[RESOLVED] Some bad unknown thing happened today, do I give a shot tonight?

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Ron

Member Since 2014
So everything was going really well with my furry friend Ratface. This morning his BG was 340, high but about where I expected it to be. He received his dose (Lantus 1.25u), ate some food and then went outside for a stroll around.

Normally he'll go wander around for 20 - 30 minutes and then come back and sleep on the deck for a couple hours before eating again and then resuming a heavy-duty nap schedule for the afternoon. Today he was gone for almost 5 hours before he returned.

When he did return, it was obvious something was wrong with him. He was moving slowly, his health thermometer was sagging (tail down) and he was really quiet. He came into the house, ignored his food and just plopped down on the floor. I took a quick BG measurement (AM+6 read) and got a result of 459, the AM+9 read was 439. There was some quiet meowing when I picked him up to test and he is moving very slowly (didn't need to wrap him in a towel to take the read, which is very unusual). He has been lying on the floor against the wall for about 4 hours now, has absolutely no interest in food, water and won't even touch the liver shake I made up for him (which he normally loves).

Unfortunately taking him to the vet is impossible today but I can get him there first thing in the morning (which is the plan unless he improves overnight).

I had some buprenorphine left from his last bout of pancreatitis so I gave him a small dose. I'm not sure what to do about his shot for the evening. Up until today his appetite has been really good but I can't imagine he'll eat and while I'm hoping I can get him to drink some water, I don't expect it to happen. With his BG this high and whatever physical problem he is suffering from should I give him his regular insulin dose tonight? (I'm about 2.5 hours from shot time now).

Thanks everyone!
 
Monitor the Secondary Monitoring Tools that you can in my signature link.
Check dehydration, smell his breath.
 
@BJM : I can do all of those things, he may have an oral infection (his breath is certainly awful - which I've mentioned to my vet before but they won't do a dental on him as it will require anaesthesia and they don't think he'd wake up from that). I can get blood glucose reads though, so I'll know exactly where it is at and can extrapolate where it is going to go. The only thing I'm not confident on is whether or not he should have insulin if he hasn't eaten for 10 hours?
 
The body can make glucose from both fat and protein which are part of the body, so it'll depend on his glucose levels. He may need a token dose.
 
Well I got in contact with the vet and rushed him down there. We figure he suffered some type of trauma (a fight, an escape or maybe kicked/attacked). No broken bones, he's lost weight from the last visit (now 3.31 kg - so about a 150 gram loss), does seem to be in some pain (so more buprenorphine tonight) and temperature was a little low (36.4 Celsius). We gave him a 120mL of subcutaneous fluid and I brought him home to monitor. He is drinking some water now, I'll shoot him up with his regular dose and monitor throughout the night. Will giving him subcutaneous fluids affect the absorption of insulin?

We're hoping that he pulls through but if not it may be time to send him on ahead over the rainbow bridge. :(
 
H
Well I got in contact with the vet and rushed him down there. We figure he suffered some type of trauma (a fight, an escape or maybe kicked/attacked). No broken bones, he's lost weight from the last visit (now 3.31 kg - so about a 150 gram loss), does seem to be in some pain (so more buprenorphine tonight) and temperature was a little low (36.4 Celsius). We gave him a 120mL of subcutaneous fluid and I brought him home to monitor. He is drinking some water now, I'll shoot him up with his regular dose and monitor throughout the night. Will giving him subcutaneous fluids affect the absorption of insulin?

We're hoping that he pulls through but if not it may be time to send him on ahead over the rainbow bridge. :(
Hugs and prayers
 
Did your vet think he may be having another pancreatitis attack? They're really common in diabetics and since he's had it before, it could be very possible that's what's going on again.

It's very painful, affects their appetite and makes them really miserable
 
No, his claws are pretty worn down (and they weren't this morning), so he was either running on asphalt or dragged.

He did perk up a bit after the fluids, even got up to drink some water but threw that up (white and frothy so I think it was just the water). He's been lying on the floor for the past couple of hours here, just got up to drink a little more. I'm hoping he'll rally tonight and be a little better tomorrow morning.
 
White and frothy vomitus may possibly be due to excess stomach acid because he hasn't eaten. Did the vet say anything about food?

Fingers and paws crossed for the little fella. Hope he feels better on the morrow.
 
Vet pretty much said that I should force feed him tonight to make sure he eats something. I didn't have the heart to syringe feed him after everything that he has been through but I did get him to start eating up the "Liver shake" recipe that is posted somewhere on here. He seems to have regained a little appetite. Now to see if he will keep it down.
 
I am so glad to hear that Ratface has eaten something. If his appetite doesn't pick up today, I'd strongly recommend going back to the vet today to ask about meds (e.g. antacid, anti-nausea AND appettite stimulant).
If Ratface is a candidate for the supportive meds and they work it would be a lot easier on both of you than assist feeding. Also ask your vet whether a B12 injection might be an idea? It can help with appetite problems.
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This lovable, wretched creature has used up more than his fair share of nine lives. The last two days were very rough. He wouldn't move much, didn't want to get picked up and just seemed miserable. Last night he looked so worn down that I was feeling really bad about keeping him going through all this and was going to call the vet this morning to make arrangements for them to come out to the house and send him on his way.

Now (with the unspoken final vet appointment looming), he is feeling much better. He was curled up with me when I woke up this morning (never happens when he's feeling bad), he's walking around with his tail in the air (aka his health thermometer) and he lead me to his food dish (a very promising sign). I gave him his liver shake and some canned food. He slurped down the shake and licked at his food so I'm starting to think that Chris and China had the right of it with the suggestion of pancreatitis. I know he has it and if this was a flare up it's the worst one I've ever seen.

He was involved in some type of stressful event on Monday but maybe it was just enough to kick his pancreas into panic mode. Hopefully this is not just a blip and that he continues to recover (especially since I'll be out of town over the weekend for business and I don't want the cat sitter to have too much stress dealing with him).

Thanks to all of you for your well wishes and suggestions. As always, this remains an amazing place and I am truly thankful for all your help and assistance!
 
First thing I thought of was DKA. Can you check urine / blood for ketones? I don't know much in ways of pancreatitis. Can buy ketostix at pharmacy I believe for urine but I use Precision Xtra monitor for blood though it's more costly, vet can also check urine for probably ~$75.

http://petdiabetes.wikia.com/wiki/Ketones

Symptoms:
High blood sugar over 16 mmol/L or 300 mg/dL
(though with low insulin, lower as well...)
Dehydration
(skin doesn't jump back after pulling a bit
gums are tacky or dry)[2]
Not eating for over 12 hours
due to Inappetance
or Fasting
Vomiting
Lethargy
Infection or illness
High stress levels
Breath smells like acetone
(nail-polish remover) or fruit.

ps: Ratface looks just like my Charlie.
 
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Surprisingly he doesn't have an issue with ketones. He did pee on the vet when we were pulling him out of the "travel prison/carriage" so it was easy to test then and there was a trace of ketones, but that is the first time since he was diagnosed that it had ever registered. I tested yesterday as well and there were none detected. I'm still having an odd issue with his insulin regulation though. I gave him his shot this morning and then just tested at +4 and he is still rising (went from 319 AMPS to 326 AM+4), but the depot might have emptied a bit due to the events of Monday, so I am going to keep monitoring. He is much more mobile than he was yesterday, so maybe he was just out trying to prove that he is still young enough to soar with the eagles. At the human equivalent of 85 years age, it will take some time to recuperate from that :blackeye:.
 
Surprisingly he doesn't have an issue with ketones. He did pee on the vet when we were pulling him out of the "travel prison/carriage" so it was easy to test then and there was a trace of ketones, but that is the first time since he was diagnosed that it had ever registered. I tested yesterday as well and there were none detected. I'm still having an odd issue with his insulin regulation though. I gave him his shot this morning and then just tested at +4 and he is still rising (went from 319 AMPS to 326 AM+4), but the depot might have emptied a bit due to the events of Monday, so I am going to keep monitoring. He is much more mobile than he was yesterday, so maybe he was just out trying to prove that he is still young enough to soar with the eagles. At the human equivalent of 85 years age, it will take some time to recuperate from that :blackeye:.

Well at least we know it's not DKA related (or can assume such).

You know Charlie (my mom has him now) went outside awhile ago and got into some poisonous (to cats) type plant and acted all kinds of weird and lethargic for 2-3 days. The vet just said keep him hydrated. Maybe something simple like that happened while he was outside? Hopefully that's the case!

How are his teeth? Luna's enduring high #'s are most likely from dental and we're brining her in for that tomorrow. Her teeth are rotten. You can also see from her spreadsheet her #'s like to rise as well on occasion despite insulin.
 
His teeth are awful. His breath smells like a dead creature in the sun, so it's always endearing when he meows in my face in the morning to get fed :). He is in need of dental work, but due to his advanced age and general poor physical condition (skinny or wraith-like depending on the day) the vet won't do a dental as it requires putting him under with anesthesia and they don't think he would wake up from it. I'd like to do something about his teeth but I have no idea what I should be looking at. Any suggestions? (I have tried to scrub them manually and fortunately still have most of my fingers so I understand why the vet requires him to be anesthetized).
 
Hmmm.. age and physical condition are definitely a problem. I'm super nervous just bringing Luna in and she's only 8 and in relatively great condition. They need to put him under to really 'get in there', manual brushing won't do much if anything at all if it's a gum/plaque/tartar type problem, which absolutely can raise BG's for long periods of time I understand.

In your case though I really don't know. If he's happy and healthy I say let him live out his days. Does he have "drooling, pawing at the mouth, food falling out when the cat eats, nasal discharge and facial swelling"? It could be hurting him. I'd rather he die of old age then on an operating table, but at the same time it could help and give him a few more months/years he otherwise wouldn't get. Your vet probably knows best here, but my vet was afraid to do it since her BG's were >300 but I told him BG's are probably high BECAUSE of the dental issues.

I think Luna and Ratface might be in this area or worse:
Stage 3, Moderate Periodontitis. Cherry red and bleeding, the attached gum is being destroyed by infection and tartar (calculus). Advancing inflammation and infection also continue to destroy the tooth root structure. Painful mouth affects eating and behavior. Bad breath intensifies.

http://www.cathospitalofchicago.com/online-cat-health-library/dental-disease-in-cats


[How did he get the name Ratface?]
 
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I'll go poke my fingers in there tonight and check. I don't think he has bleeding gums, no real drooling either. Does get the occasional food falling out of mouth when eating but I chalk that up to clumsiness.

As for the name, this is what happens when the family can't decide on a name quick enough. We were tossing names around trying to find one that suited him and my brother walked into the house and said "Look at his cute little rat face!" Once he said it we knew we were stuck with it. It is super awkward when you are calling for him to come into the house at night or we are at the vets and they call out his name :) On the upside, once someone has met him, they tend not to forget the name.
 
Sounds good. I think it's really a choice you'll have to make. He seems like a happy guy though.

Lol I like Ratface. Our gray tabby was named Baby after being called "gray cat" for about 6 months, because she whined like a baby all the time.

So far my favorite names I've seen on this site are Vegetable and Ratface!
 
You're more creative then me. If it was up to me our former cats would have been gray & white cat, followed by black and gray (again) cat, and Luna is nicknamed 'Bug' because she looks like the queen of bugs (the whiskers). We named her Luna specifically because she was the 'size of the moon' when we got her :D
 
My others: Spuds, because he looks like Spuds MacKenzie. 614998_10200774748511546_1447556650_o.jpg

Franki, because when I got her she was grey with blue eyes, like Frank Sinatra. 3758_1061186970401_7434513_n.jpg

And Jersey, because her spots reminded me of a cow. 3758_1061182930300_5541109_n.jpg
 
@Ron,
FWIW, Mitz is 20 and had a successful dental in April so it can be done safely with older kitties. But, she's at a good weight and her diabetes is well-regulated. I was extremely nervous about it but took her to a vet dental specialist because they could do x-rays and monitor everything under the sun during the procedure.

Glad to hear he's continuing to feel better! It could possibly be residual stress from whatever he went thru that's keeping his BG on the high side right now. Maybe the numbers will settle down in a day or two? Keep us posted.

Joan
 
@Mitzelplik's Mom Unfortunately Ratface is still way underweight (we just can't seem to put weight on him) and I think because of that and his dental I can't get his BG levels regulated as well as I like to. It's definitely a Catch-22 situation.

He is doing much better today though. He's almost ready to start eating canned food again (still a lot of licking going on), but he is hungry so I've been feeding him liver shake and boiled chicken breast which he is devouring. While his numbers were high this morning they did come down nicely for the +6 read. I'm a little nervous about him as I have to leave on a business trip for 4 days and there will be no one to run tests on him (but I do have someone to give him his insulin shot). I'm going to keep him at 1.5 units while I'm gone and then I'll run a curve when I get home and see how he is coming along.

Here's hoping for the best!
 
He did pee on the vet ...

... and kittehs teh wurld over did rejoyz wiht grayt gladnezz! :smuggrin:


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Wonderful news that Ratface is feeling better and eating again. It is always such a relief! I'm delighted for you both.

It can be very, very frightening to see how terribly ill a cat can look during a major pancreatitis flare. The trick is to remember that where there's life there is hope, hold one's nerve, keep the kitty as stable as possible and give the treatments a bit of time to work. It still astounds me how quickly they can rally and bounce back when the treatments start to work. Astounding creatures, our little ones. :)


Mogs
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It is super awkward when you are calling for him to come into the house at night or we are at the vets and they call out his name ...

Tell me about it. One of my first two rescues accidentally ended up with the name Psycho Fatboy the Third ... :oops::rolleyes:
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Unfortunately Ratface is still way underweight (we just can't seem to put weight on him)

Might be worth putting a shout out on Feline Health to see if anyone can recommend some sort of calorie-dense recovery food that's fairly OK for diabetics. (Or possibly search some DKA threads.)
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Luna is nicknamed 'Bug' because she looks like the queen of bugs (the whiskers). We named her Luna specifically because she was the 'size of the moon' when we got her :D
I keep doing double-takes when my eye lands on your signature. My civvie is called Lúnasa, and one of her nicknames is Noodlebug.


(* Irish for August, the month of her birth.)
 
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