Inappetance

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dsmithkma

Member Since 2013
Hi All-

I'm so glad I found this forum! It's nice to know I'm not alone in this "adventure".

My 15 year old male tabby, Kitten, was recently diagnosed diabetic. He went in yesterday for his first glucose curve. It was 293 at 7:30 AM. They gave 1 unit of Lantis. His "ending" reading was 169 at 5 PM. We brought him home yesterday and gave him his Purina DM and he barely ate anything. We did NOT give him his insulin.

This morning he, again, barely had a few bites and again we did not give his insulin. We've tried plain water packed tuna, Pro Plan, even turkey breast.

He's lethargic and "out of it". He is drinking his water.

Could his inappetance be from the stress of yesterday's curve testing? ANy tips or tricks to get him to eat something.
 
What food did he used to eat? The most important thing right now is to get your cat to eat. anything. He may not like the new food.

A cat not eating for a couple of days can lead to hepatic lipidosis.

Can you hand feed him?

Please smell his breath. Does it smell like acetone (nail polish remover) or a sickly sweet fruity odor? This is a sign of ketones and can lead to diabetic ketoacidosis (DKA) , a life threatening and expensive condition to treat. No eating, not enough insulin and a possible infection are the perfect setup of conditions that can lead to DKA.
 
Deb & Wink said:
What food did he used to eat? The most important thing right now is to get your cat to eat. anything. He may not like the new food.

A cat not eating for a couple of days can lead to hepatic lipidosis.

Can you hand feed him?

Please smell his breath. Does it smell like acetone (nail polish remover) or a sickly sweet fruity odor? This is a sign of ketones and can lead to diabetic ketoacidosis (DKA) , a life threatening and expensive condition to treat. No eating, not enough insulin and a possible infection are the perfect setup of conditions that can lead to DKA.
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Thanks for the reply. I've tried hand feeding him and he only nibbles.

No acetone smell, thank goodness.

He used to eat Iams weight management, hairball formula.

I now know a low carb-high protein diet is best.
 
dsmithkma said:
Hi All-

I'm so glad I found this forum! It's nice to know I'm not alone in this "adventure".

My 15 year old male tabby, Kitten, was recently diagnosed diabetic. He went in yesterday for his first glucose curve. It was 293 at 7:30 AM. They gave 1 unit of Lantis. His "ending" reading was 169 at 5 PM. We brought him home yesterday and gave him his Purina DM and he barely ate anything. We did NOT give him his insulin.

This morning he, again, barely had a few bites and again we did not give his insulin. We've tried plain water packed tuna, Pro Plan, even turkey breast.

He's lethargic and "out of it". He is drinking his water.

Could his inappetance be from the stress of yesterday's curve testing? ANy tips or tricks to get him to eat something.
Click to expand...

Welcome to the site.

Kitten won't the DM food from the vet; what were you feeding him before? Not alot of cats like that DM, and the good news is that you don't need to feed it to Kitten.
Here is a list of food compiled by Dr. Lisa Pierson... stick to low carb wet food under 10% and you will be fine.... most people just feed fancy feast or friskies pate flavors; stay away from the gravies and grilled and marinated, and remove all dry foods.
catinfo.org/docs/FoodChartPublic9-22-12.pdf
Feeding Your Cat: Know The Basics of Feline Nutrition

Next is home testing.... the stress would be from being stuck at the vet's office all day, not the testing, but YOU can pick up a meter, test strips and lancets at the pharmacy and test Kitten yourself at home where Kitten will not be stressed. Most people in the US just get a Relion meter at Walmart I think as it has the most economically priced test strips. Other meters are good like the Bayer Contour, OneTouch, Accu-Chek...just do not get any of the FreeStyle or TRU2GO as they give unreliable numbers.

Judging by the 2 numbers you gave from the vet curve, the 1u dose may be too much Lantus...usually, you may get a number like that 293 at shot time, then the insulin brings the number lower around mid-cycle and then, 12hrs later, the number may be close to the start of the 12hr curve... but yours was only 169 after 9.5hrs.

Kitten likely feels lousy..... taken to the vet, tested, given insulin,tested all day long, then the insulin wears off and he feels worse, but it's hard to tell without know what his numbers are.

If you were feeding wet food before, check for it on the list above. If it's 10% or less carbs, go back to your old wet food and return the DM to the vet saying Kitten won't eat it. Otherwise, pick up a can of a few flavors under 10% carbs on the list and find something that Kitten likes.
Next, get yourself a blood glucose meter and start testing Kitten. Most people here will have the same issues you may have and they have suggestions to help you.
Depending on the numbers you get, maybe Kitten needs less insulin.

Gayle
 
Does he like any of the Fancy Feast classic pates or the Friskies pates? Those are all low carb.

When the calorie intake is insufficient (starvation, diabetes, inappetance, etc), fat will break down for calories. In as few as 2 days, it is possible for that to overwhelm the liver, starting hepatic lipidosis which messes up the metabolism considerably, including the liver enzymes.

Some antibiotics can cause inappetance.
Pancretitis can cause inappetance. Is the cat 'meatloafing"?

About stimulating the appetite:
- Try warming the food. (I assume your cat is on wet food?)
- Try sprinkling the food with parmesan cheese if you have it.
- Try sprinkling the food with Fortiflora (a probiotic that can stimulate appetite) if you have it.
- Try another type of food.
- Sprinkle some freeze-dried treats (like Halo's Liv-A-Littles) on the food.
- Try hand-feeding.
- Offer any special-treat type foods: chicken meat (boiled/raw/cooked/fried in butter - whatever he'll take), a little canned tuna.

The most important thing right now is to get your cat to eat something. The home testing can wait.

Lets' concentrate on getting Kitten to eat.
 
Yes, the vet said to give him 1/2 unit 12 hrs apart. However, we have not yet given him any, as he hasn't eaten enough and I don't want to risk hypoglycemia.

At this point, we're trying to get him to eat ANYTHING. He did eat a few Temptations treats but that's it.

I have a testing meter but am hesitant to test him since he's so puny right now.

I'm so worried about how lethargic he is. I calle dthe vet and they said just to try and get him to eat anything. If he's not eating by Monday, to bring him in.
 
Deb & Wink said:
Does he like any of the Fancy Feast classic pates or the Friskies pates? Those are all low carb.

When the calorie intake is insufficient (starvation, diabetes, inappetance, etc), fat will break down for calories. In as few as 2 days, it is possible for that to overwhelm the liver, starting hepatic lipidosis which messes up the metabolism considerably, including the liver enzymes.

Some antibiotics can cause inappetance.
Pancretitis can cause inappetance. Is the cat 'meatloafing"?

About stimulating the appetite:
- Try warming the food. (I assume your cat is on wet food?)
- Try sprinkling the food with parmesan cheese if you have it.
- Try sprinkling the food with Fortiflora (a probiotic that can stimulate appetite) if you have it.
- Try another type of food.
- Sprinkle some freeze-dried treats (like Halo's Liv-A-Littles) on the food.
- Try hand-feeding.
- Offer any special-treat type foods: chicken meat (boiled/raw/cooked/fried in butter - whatever he'll take), a little canned tuna.

The most important thing right now is to get your cat to eat something. The home testing can wait.

Lets' concentrate on getting Kitten to eat.
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What is "meatloafing"?
 
Meatloafing:

If you observe 'meatloafing', where the cat hunches in a crouched position, that can be a sign the cat doesn't feel well.
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Is he laying in what we call the "meatloaf" position, with his paws tucked under him and his head hanging down? That position can indicate feeling bad, especially if they do it much of the time.
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she was hiding or sitting in a ball like a meatloaf
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she was on her rocking chair, legs tucked in, head on its side, staring at the wall (meatloaf position?). She was tensing her body about every 5-10 secs; in discomfort of some sort.
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No, no meatloaf position.

He is sleeping right now, and looks to be breathing fine.

I hate this helpless feeling and heve shed quite a few tears today. And I, as a man, freely admit it :mrgreen:
 
dsmithkma said:
No, no meatloaf position.

He is sleeping right now, and looks to be breathing fine.

I hate this helpless feeling and heve shed quite a few tears today. And I, as a man, freely admit it :mrgreen:
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what was he eating before? if he won't eat what he was eating before all this diabetes stuff, it's not the food.

What test meter do you have.... since Kitten's sleeping and doing ok from what you can see, let's see if we can start on the testing...there are lots of people around and we can help you.

You have a meter, and the test strips for that meter as well as the lancets to put in the lancet device to be used to poke the edge of Kitten's ear?

Do you want pictures where to test and maybe some youtubes to watch?
Just let us know why your hesitation and we can help you overcome the problem

Gayle
 
Let Kitten sleep. Maybe try to get him to eat some food later.

Welcome to FDMB. The best place you never expected to be. We care for diabetic cats 24/7 and our collective knowledge is immense, especially with the day to day management of a diabetic cat.

Would you please tell us your name and where you live. We have members around the world, most in the US and Canada.

This can be a very stressful time for you as a new caregiver for a newly diagnosed diabetic cat. There is a lot to learn. I equate this with a crash course, college masters degree level in managing feline diabetes.

We try for some best practices here, a good long lasting insulin (lantus, check), good low carb food ( d/m, ok, check), the correct dose of insulin (1U, not sure yet, may be too much), home testing (not yet, maybe later)

Sometimes, a diet change from a high carb food to a low carb food can make all the difference. A cats BG (blood glucose) levels have been known to drop 100 points on diet change alone. Cats have been known to go into remission on this low carb diet alone.

Did your vet mention home testing?
 
You might want to try sryinge feeding.

Pick up a childrens's oral syringe at the pharmacy and then mask up some low carb canned food with warm water, suck it up in the syringe, and a small amount at a time, give the mushy food.

Watch for signs of nausea - lip licking after smelling food, then walking away, actual vomiting. Pancreatitis can cause inappetance, vomiting, and pain.

See my signature link secondary Monitoring Tools for additional methods of assessing your cat.
 
Thank you all for your responses!

I tested him this morning using an AlphaTrak, he had not eaten anything, and his BG was 198. I am hesitant to test him right now, as he's spleeping peacefully. I am fully confidant in how to test and my vet encourages home testing.

He did manage to eat about 2 teaspoons of warmed-up tuna (better than nothing) before sleeping. At this point I'll take whatever he'll eat.

If he doesn't eat later, what about some honey or Kayro syrup, just to get some calories in him?
 
Hi Dan from Tennessee. You are outnumbered here by the cat mamma's, although, we do seem to be getting more cat pappa's lately.

The honey or karo syrup will cause his BG's to go up. We only like to use that when a cat's numbers are too low and we are trying to get them higher quickly. I would rather see some solid food in Kitten.

I usually wait a bit until I ask for this but would you be willing to put some information in your signature? Sort of a list of details about you and your cat.

Would you please provide us with some more information and put this in your user control panel? It helps us to help you better.

Go to the upper left corner of your screen and click on the words, User Control Panel
On the next screen, a row of tabs is presented. Select the Profile tab
On the next screen, there are a number of choices along the left hand side. Select Edit Profile.
Go down to the location field and enter your country, state/province, and city if you are willing to share that info.
Click on submit to save this change.

Still in the User Control Panel, Profile tab, this time select Edit Signature from the left hand list of options.
A free form text box appears.
We like to see information like your name, your cats name age and sex, the diagnosis date for the diabetes like this (DX 4/30/13), what meter you are using for testing, what insulin you are using , what you are feeding (wet or dry, what brands/style of food), any complicating health issues your cat may have, any additional medications your cat is receiving. If you are using a pet specific meter like an Alphatrak or Ipet, please change the font size on that text from Normal to Large (using the drop down arrow list in the middle of the editing commands)

Click on submit to save this information. Now, this will appear at the end of every post you make. You can update the info when you need to.

Think of this as having some very useful information at our finger tips for those that are replying to your posts.

Would you please do those updates when you get a chance? Thanks.
 
Thank you. For the info in your signature.

Are you interested in learning to home test the blood glucose levels?

ETA: I see that you already said you were confident in your home testing and have a supportive vet in that regard.
 
I think he is home testing, as had already been posted.... maybe you would like to suggest he set up a google spreadsheet to record the numbers?

Gayle
 
Yes. I am home testing. However, he was given his very first insulin this past Friday, 6/7/2013.

Since he's barely eating anything at all, I have not given him any Lantis today (Saturday).

He did just now (3:00 PM Central) eat a few bites of warmed tuna, but just a few.
 
Blue said:
I think he is home testing, as had already been posted.... maybe you would like to suggest he set up a google spreadsheet to record the numbers?

Gayle
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Yes, I intend to do this, once I get him to eat and start his Lantis.

I'm just worried he's not eating and I've tried a variety of foods: Fancy Feast, his old Iams dry food, and tuna (which he did eat a little bit).

This is really emotionally draining :YMSIGH:
 
Hi Dan! Welcome! You may wish to try a few pieces of dry kitten food, that's what my Pudge ate after refusing everything else. Knocked him out of remission, but he lived. We're working on a 2nd remission right now. Dry kitten food is now part of my emergency kit. Best wishes, Sophie
 
sophie said:
Hi Dan! Welcome! You may wish to try a few pieces of dry kitten food, that's what my Pudge ate after refusing everything else. Knocked him out of remission, but he lived. We're working on a 2nd remission right now. Dry kitten food is now part of my emergency kit. Best wishes, Sophie
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I tried some of his old food, but he refuses to eat it.
 
My Pudge is 13 y/o so he hasn't been on kitten food in years, so I purchased a fresh box of kitten food (meant for the teeny munchkins!). Just want to make sure I made myself clear. I like your kitty's name, just want to make sure that I didn't mean what your Kitten usually ate. Best, Sophie
 
No. Thankfully he is taking in water. I've seen him drink 3 times today.

And I am thankful for that.

I spoke to a vet at a local animal hospital (who also has a diabetic cat so she was sympathetic), She said it's fairly normal for a cat to refuse food at first and can be a pain in the rear. She said try a 1/4 of a tablet of Pepcid, as he may have an upset stomach. She also said to call her back if we had any further questions and she'd be there all night. That is somewhat reassuring.

Thanks for the link. I check it out.
 
You want the plain 10 mg Pepcid AC with nothing else added to it. Most useful when given 15-30 minutes prior to regular feeding times.

If he won't eat enough in today and tomorrow, you may need to start assisted syringe feeding, or possibly have a PEG tube inserted by a vet until he will eat on his own again.Two or more days of inadequate calories sets a cat up for hepatic lipidosis which can be fatal. Look for yellowing of the skin and the whites of the eyes (jaundice).

There is a Feline Assisted Feeding support group on Yahoo that has been highly recommended by members of this board here that may help.
 
Well, I gave him 1/4 of the Pepcid by crushing it up, mixed it with a little water, then used a syringe to give it to him. He did not eat right away, but did nap for an hour.

When he woke up, he ate apprx. 1 oz. of Pro Plan chicken and tuna. Small victory?
 
Thanks!

It's just so strange that yesterday morning, before he went in for his curve, he ate 1/2 of a 5.5 oz. can of DM with gusto.

Then when we got back home yesterday afternoon with him, he was just not interested in eating. I suppose the stress from being at the vet all day really affected him and, perhaps, still is.

I so appreciate everyone's responses.
 
Great! Sounds like the Pepcid helped. You can do that daily for a while, though do check with the vet on how long to continue it. There are some Rx meds for appetite and vomiting if the Pepcid doesn't do enough.

If you glucose test and find that he is over 200 mg/dL, a small dose of insulin (ex 0.25 - 0.5 units) may provoke more eating by lowering the blood glucose level and causing hunger.
 
BJM,

You mentioned earlier that pancreatitis can cause inappetance, vomiting, and pain. Kitten is not vomiting and I don't "think" he's in pain.

He ate heartily Friday morning before the vet curve visit. Could pancreatitis have manifested itself so fast or is it more likely he's still stressed out from his visit?
 
Stress from vet visits can really upset some cats. If yours has a history of this, that might be more likely. If this is new, it could be something different, or something triggered or aggravated by vet stress.
 
Good news!

This morning I awakened at 5:30, checking on Kitten. He greeted me at the bottom of the stairs with a "hey daddy...I could use a bite to eat." He ate 2 oz of tuna!

I went back to bed for a bit and then fed them (we have 4 additional cats) at 9 AM.

Kitten had 1/2 can of Fancy Feast Classic, sole and shrimp! We'll see if he'll eat again in a few hours or so.

He certainly has a spark back in his eyes and even a bit of attitude :-D
 
I got him to eat about an ounce of Fancey Feast at 10:30 AM after his nap.

Considering he ate pretty decent at 5:30 AM and 9 AM and just now (10:30 AM), I'm feeling better about him.

My plan is to try and offer him small meals throughout today, perhaps every 1.5-2 hours. My thinking is small, frequent meals will be easier on his system and then we can get him up to more food volume per meal as we progress.

AGain, thank you all for the encouragement and sage advice!
 
BJM said:
Stress from vet visits can really upset some cats. If yours has a history of this, that might be more likely. If this is new, it could be something different, or something triggered or aggravated by vet stress.
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Other than his regular vet checkups, he has, thankfully, never had an extended vet stay. His curve was the longest he had ever been at the vet's office.

He's a really laid-back easy going guy normally.
 
1. Even if you don't give the insulin, a test to see what his BG numbers are would be good. The food change to a lower carb food can make a big difference on it's own. You could try that for a few more days, just the food change, and get a BG test in the mornings and in the evenings.

This would tell you how the food change is impacting his blood glucose numbers.

2. If he's eating better, it may be time to start thinking about giving him some insulin. How do you feel about that?
I'm a little leery of starting the insulin myself at this point. I'd want to see a better appetite first.
 
Deb & Wink said:
1. Even if you don't give the insulin, a test to see what his BG numbers are would be good. The food change to a lower carb food can make a big difference on it's own. You could try that for a few more days, just the food change, and get a BG test in the mornings and in the evenings.

This would tell you how the food change is impacting his blood glucose numbers.

2. If he's eating better, it may be time to start thinking about giving him some insulin. How do you feel about that?
I'm a little leery of starting the insulin myself at this point. I'd want to see a better appetite first.
Click to expand...

Deb,

I agree completely! I'd like to see him continue to eat before I administer the insulin. If he eats well tomorrow morning, I'll take a BG level and go from there. I'm leery of testing him right now, just too concerned that it may stress him out.

Do you agree with my plan today of small frequent meals?
 
Do you agree with my plan today of small frequent meals?
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Yes, definitely on the small frequent meals. That way, he won't eat too much at one time and possibly vomit it back up. Let's take this slow and easy.

Does he like to have his ears touched and rubbed? You could start that step in the process of home testing. Getting him more familiar with having his ears touched. Give him a little treat after. Do you have anything that is pure meat? Fresh, cooked or freeze dried are good. Nothing with spices or too salty. Give that to him after the ear touching and tell Kitten 'what a good boy' he is.

Have you read this document on ear testing psychology, getting your cat more comfortable with the process? Written by member Kpassa. https://sites.google.com/site/michelangeloprofilefdmb/feline-diabetes/ear-testing-psychology

Might be good to read in case the appetite issue was stress related. We don't want the home testing process to be stressful.
 
I tested him this past Thurs and while he didn't enjoy it, he tolerated it. So I think we will get there. I have no compunction against testing him and am committed to doing what we need to.

I used a Kleenex, folded many times and held it on the inside of his ear so as not to prick myself. The two times I did it, I got good blood with "reasonably" minimal fussing.

Update: AT 12:15 (cst) he ate approx. an oz. of the FF food. So far today he's had 2 oz. tuna, and just under a full can of FF. I'd love to have him eat at least one more can of FF before tonight.
 
Dan, Thank you so much for popping in on new member Hurricanegirl's first post. It makes all the difference to hear from another new member.

Did you give him a little treat after the ear poke?

I use a folded up piece of toilet tissue paper. I find it to be the perfect size.

Update: AT 12:15 (cst) he ate approx. an oz. of the FF food. So far today he's had 2 oz. tuna, and just under a full can of FF. I'd love to have him eat at least one more can of FF before tonight.
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Me too. :mrgreen:
 
Absolutely on Hurricanegirl. You all were so encouraging with me yesterday, I wanted to let her know she's not alone.

I plan on giving a treat when I test to make him more receptive to it.
 
dsmithkma said:
Deb & Wink said:
1. Even if you don't give the insulin, a test to see what his BG numbers are would be good. The food change to a lower carb food can make a big difference on it's own. You could try that for a few more days, just the food change, and get a BG test in the mornings and in the evenings.

This would tell you how the food change is impacting his blood glucose numbers.

2. If he's eating better, it may be time to start thinking about giving him some insulin. How do you feel about that?
I'm a little leery of starting the insulin myself at this point. I'd want to see a better appetite first.
Click to expand...

Deb,

I agree completely! I'd like to see him continue to eat before I administer the insulin. If he eats well tomorrow morning, I'll take a BG level and go from there. I'm leery of testing him right now, just too concerned that it may stress him out.

Do you agree with my plan today of small frequent meals?
Click to expand...

Dan,
Be VERY careful holding back the insulin.... 2 of the ingredients for DKA are not enough insulin and not enough food.
If he is eating some food, give him his insulin or you could end up with a very sick cat at the ER.
Withholding insulin is not a very good idea.

Gayle
 
Actually ... what is his current glucose level. Let's start there, now that he is eating again.

If it is over 200, it should be safe to shoot a small dose at what you want his regular shot time to be, to see how he does with it. I'm being conservative here, in suggesting to start low.
 
BJM said:
Actually ... what is his current glucose level. Let's start there, now that he is eating again.

If it is over 200, it should be safe to shoot a small dose at what you want his regular shot time to be, to see how he does with it. I'm being conservative here, in suggesting to start low.
Click to expand...

I'm just afraid to test him, for fear of upsetting him and he stops eating.

I swear, I am going to tell the vet tomorrow, it's not a good idea to do a glucose curve on a new diabetic on a Friday. I have too many fears and unassured and would be nice to be able to talk to the vet.
 
dsmithkma said:
BJM said:
Actually ... what is his current glucose level. Let's start there, now that he is eating again.

If it is over 200, it should be safe to shoot a small dose at what you want his regular shot time to be, to see how he does with it. I'm being conservative here, in suggesting to start low.
Click to expand...

I'm just afraid to test him, for fear of upsetting him and he stops eating.

I swear, I am going to tell the vet tomorrow, it's not a good idea to do a glucose curve on a new diabetic on a Friday. I have too many fears and unassured and would be nice to be able to talk to the vet.
Click to expand...

Why would testing the cat cause the cat to get upset and stop eating?
My cats usually came to me to remind me it was time for testing, or they just slept through my poking their ears, and many other cats also get used to a routine, a special testing spot, and they just go there on their own.

Don't forget to factor in the 50points or so when testing with your pet meter..... you number will be higher than what others mention.

Go ahead and test; he won't stop eating.

Gayle
 
Welcome to the best place you never wanted to be! :-D

dsmithkma said:
I'm just afraid to test him, for fear of upsetting him and he stops eating.
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That's a valid concern. Is he a lap cat at all? Will he willingly sit next to you or on you? One thing you can do is prepare both of yourselves with getting ready for testing. When he's near you or around you, just start casually playing with his ears. Don't try to test or anything, just fiddle with his ears and see if you can spot the Marginal Ear Vein that runs along the outer edge of the ear. Fold his ears down and up and every which way to determine which angle might be best for you to spot the vein. Then, give him a few treats and cuddles. Just keep doing that all day long till you're both feeling comfortable and then proceed to the next step (maybe clicking the lancing device in his ear if you're using one).

It's helpful to know that their ears are less sensitive than our fingertips, so they feel it even less than you do. The stress comes from the cat picking up on your stress, from having their "routine" change, and even from simply being restrained. If you can figure out techniques to work around those stressors first, then you'll both be much happier. :-D
 
I'm not afraid of testing him. He was diagnosed on Wed. Had a glucose curve at the vet's on Fri. (he ate at 7AM) and didn't eat Fri. night and only ate a bit on Sat.

Today, he is doing quite a bit better, havng taken in so far about 6-7 oz of Fancy Feast and a little tuna. I've been feeding him a little bit every 2 hours or so.

I've already tested him and am very comfortable doing it. Given his calorie deficiency yesterday, I just want to ensure he keeps eating today.

I got him off the dry junk cold turkey, so I suspect his system is a bit "off". Tomorrow, I plan on testing him and if he eats decently, give him his insulin (1/2 unit).
 
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