10 yr old newly diagnosed refused to eat (and he is now eating thanks!)

[Mandy Lai]

Hello to all! This is Siu Bo and Mandy from Macau. Siu Bo is my feline brother, he turned 10 this August and has been newly diagnosed of diabetes last Friday 8 September. He's lost a kilo from 7kg early August to 6kg now. He's been on Lantus since then and his blood glucose has been under controlled. However he still refuses to eat by himself and we have to syringe/finger feed him chicken broth and baby food. Luckily his ALKP has come down to 138 from 207. However his potassium level is still low at 2.6, and the vet said this is the major reason he still refuses to eat.

He's now on KaliGel and also saline fluid with double portion potassium, and the vet said he'll need to hospitalised for IV if his potassium level is not improving enough, which is difficult since he's really really reluctant to leave home, and he almost torn down the vet clinic last time he had his dental cleaning (sorry Dr!)

We were able to syringe feed him almost 40 ml of home made concentrated chicken broth, 10 ml of baby food, 2 tsp of KaliGel, and he is willing to drink water by himself. And he starts to play with his scratch board, jumps on our beds to sleep, and even groomed himself for 20 whole minutes.

He looks more energetic today, and he's not so resistant to syringe feed. Dad, Mum and I sort of planned to ask the vet if we keep on syringe feed him, is it possible that he will gain his potassium level back to normal, since the major concern now is to get him to eat, we really dont want him to be hospitalised (and scare the hell outta him) to treat his low potassium.

I wonder if you could please gimme me some advice on this? I'm so confused now.

 

[Bron and Sheba (GA)]

My cat Sheba had no appetite when she was first diagnosed. It improved after a week or two.
Has your vet suggested something for nausea. Perhaps Sui Bo is nauseated and that is why he won't eat. Cats must eat every day so it is important you get some food into him.
I can't help with the potassium levels, I am sorry.

 

[vbc2000]

Hello and welcome. Many of us have been there with the no eating. My cat went thru it but please keep this in mind...once their glucose is controlled, they naturally eat less. Not nothing though. I believe it is a vicious cycle...they don't feel well because of the potassium in your case, so they don't eat, which makes them more unwell.

It sounds like you are giving him the double potassium saline at home right? If that is the case, and it still doesn't correct itself, I'm afraid you might have to hospitalize him to get him back on the right track. Could the choice of food be doing it? When Tigger was not eating, they told me to give him whatever he would eat. Some days it was handfulls of Temptation treats but at least he ate some.

I hope you can get this under control without hospitalization but keep it in mind as a step you might have to take to get him back on track. He is a very lucky boy to have you to syringe feed him and care so much. You will get this all sorted out. The people here are wonderful and much more knowledgeable than me, I'm sure someone else will chime in soon.

 

[Larry and Kitties]

and his blood glucose has been under controlled.

Just what are his BGs?
If really under control then I see no problem with you bringing Siu Bo home and syringe feeding him. You will likely have to periodically go to the vet to get blood test to determine if potassium, and other values are OK.
You have to syringe enough food to maintain his weight and is is equal to about one 5.5/6 OZ can a day.
I have syringe fed many of my cats, some for over a year.

 

[Mandy Lai]

Thank you all very much for your kind advice! Sorry for not being able to come back sooner, the previous two days had been a rollercoaster! Now Siu Bo is sleeping soundly on my bed behind me and snoring ^^||
After feeding him mom's chicken broth and babyfood and KaliGel for the day, his potassium level has risen back to 3.5 (in 9 hours!!!), and also his ALKP has decreased back to normal level, and this morning he started to eat again!!! We are just back home from the vet for the daily check up, everything looks fine, and the vet said as long as i keep monitoring his blood glucose level and keep him on Lantus, he should be okay and there's no need to visit the vet for the time being. but in the long run, he should lose weight, yet for the time being, the most important task is to get him to eat normally.
His next visit will be in a month's time, and the vet said since Lantus seems to act on him for 24 hours, there is chances that he can be cured. But it's too soon to say anything, I'm more that happy that he's now back to his happy and energetic self I just syringe fed him another 10ml of chicken broth, he seemed to start enjoying the taste.

Thank you all again for your kind concern and support. I'll keep updating Siu Bo's progress, and I hope every baby here will be healthy and happy!

 

[Larry and Kitties]

Glad that Siu Bo seems to be recovering.

 

[Mandy Lai]

Again, thank you everyone for your kind replies and your kind support! Siu Bo seems to be getting better, this morning he woke me up at his usual breakfast hour and had a few bites, I had never been this happy to be woken up from sleep!

Allow me to post Siu Bo's BG readings here, thanks!

170908/20:00-BG24, Lantus 3 units

170909/10:20-BG1.9, hospitalised for IV, 19:00 BG16.5, Lantus 1.5 units

170910/08:00-BG22, Lantus 2 units, 15:30/BG2.6, 18:15/BG2.3, 20:00/BG3.7, 22:00/BG4.3

170911/00:00-BG4.8, 03:00/BG7.5, 08:00/BG12.2, Lantus 1 unit, 17:00/BG9.8, 20:00/BG17.6, Lantus 1.5 units

170912/00:15-BG11.6, 08:00/BG8.3, 12:00/BG4.9, 16:00/BG7.0, 20:00/BG16.6, Lantus 1.5 units

170913/00:00-BG5.4, 08:00/BG3.8, 20:30/BG17.8, Lantus 1.5 units

170914/00:58-BG10.8, 07:37/BG3.3, 20:30/BG18.3, Lantus 1.5 units

170915/00:35-BG2.6, 07:25/BG3.7, 16:10/BG6.7, 18:27/BG10.4,

 

[Kris & Teasel]

Again, thank you everyone for your kind replies and your kind support! Siu Bo seems to be getting better, this morning he woke me up at his usual breakfast hour and had a few bites, I had never been this happy to be woken up from sleep!

Allow me to post Siu Bo's BG readings here, thanks!

170908/20:00-BG24, Lantus 3 units

170909/10:20-BG1.9, hospitalised for IV, 19:00 BG16.5, Lantus 1.5 units

170910/08:00-BG22, Lantus 2 units, 15:30/BG2.6, 18:15/BG2.3, 20:00/BG3.7, 22:00/BG4.3

170911/00:00-BG4.8, 03:00/BG7.5, 08:00/BG12.2, Lantus 1 unit, 17:00/BG9.8, 20:00/BG17.6, Lantus 1.5 units

170912/00:15-BG11.6, 08:00/BG8.3, 12:00/BG4.9, 16:00/BG7.0, 20:00/BG16.6, Lantus 1.5 units

170913/00:00-BG5.4, 08:00/BG3.8, 20:30/BG17.8, Lantus 1.5 units

170914/00:58-BG10.8, 07:37/BG3.3, 20:30/BG18.3, Lantus 1.5 units

170915/00:35-BG2.6, 07:25/BG3.7, 16:10/BG6.7, 18:27/BG10.4,

I'm glad he's feeling better. I'm also glad you're testing BG at home. Here are my thoughts after looking at your data:

• There have been several dose changes close together. That can lead to very erratic BG levels as you have been getting
• There are large differences between the highest and lowest BG on most of the days you've lites. That can be a sign of too high a dose causing a phenomenon we call "bouncing".
• The BG has dropped very low on several occasions. Anything below 3 - 4 is very low.
• It seems that only one dose was given on some days. Lantus works best given twice a day 12 hours apart.

I suggest that:

• you set up the spreadsheet we use here and input all this data. We can see at a glance how your kitty is doing and will be able to give advice more easily
• you stick with the same dose both AM and PM and give it 12 hours apart every day
• you try 1 unit twice a day for a week and gather BG data to get a baseline for your kitty because it's hard to know what's going on right now.

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

Routine = stability when treating feline diabetes. That includes, dose size, dose timing, food given, etc. Too many changes create confusion. I suggest you post on the Lantus forum for more help. There are yellow info stickies at the top of that forum's page that give a lot of detail on how this insulin works and how to use it best.

 

[Mandy Lai]

I'm glad he's feeling better. I'm also glad you're testing BG at home. Here are my thoughts after looking at your data:

• There have been several dose changes close together. That can lead to very erratic BG levels as you have been getting
• There are large differences between the highest and lowest BG on most of the days you've lites. That can be a sign of too high a dose causing a phenomenon we call "bouncing".
• The BG has dropped very low on several occasions. Anything below 3 - 4 is very low.
• It seems that only one dose was given on some days. Lantus works best given twice a day 12 hours apart.

I suggest that:

• you set up the spreadsheet we use here and input all this data. We can see at a glance how your kitty is doing and will be able to give advice more easily
• you stick with the same dose both AM and PM and give it 12 hours apart every day
• you try 1 unit twice a day for a week and gather BG data to get a baseline for your kitty because it's hard to know what's going on right now.

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

Routine = stability when treating feline diabetes. That includes, dose size, dose timing, food given, etc. Too many changes create confusion. I suggest you post on the Lantus forum for more help. There are yellow info stickies at the top of that forum's page that give a lot of detail on how this insulin works and how to use it best.

Thank you very much for your detailed response and instruction. I'm truly grateful, and I'll start the spreadsheet in a minute.

However, may I have some advice since just now I tested Siu Bo before his daily dose at 20:30 he's having BG7.8/8.0 (right ear/left ear, I double checked just to be sure). According to the vet's instruction, none should be given with BG below 10.

The previous changes in the dose had been prescribed by the vet. The tricky part is, the "original vet" who's been seeing Siu Bo since he's a baby is currently on vacation and will be back only on the 22nd of September. Siu Bo has been diagnosed last Friday and he's been treated by the "visiting vet" since, the visiting vet's really helpful, as I brought Siu Bo to the clinic everyday since he's been diagnosed for blood test and check up. However yesterday was the visiting vet's last day, and now I have no one to seek advice.

Just now I called the clinic to confirm, the nurse advised that I should check Siu Bo's BG again at 08:00 tomorrow and follow the scale to decide on the dose, as the visiting vet has instructed that below 10, none, between 10 and 15, 1 unit, above 15, 1.5 units.

My apologise for my confusing message, English is not my first language and I'm really worried now.

Thank you again for your kind response.

 

[Kris & Teasel]

Thank you very much for your detailed response and instruction. I'm truly grateful, and I'll start the spreadsheet in a minute.

However, may I have some advice since just now I tested Siu Bo before his daily dose at 20:30 he's having BG7.8/8.0 (right ear/left ear, I double checked just to be sure). According to the vet's instruction, none should be given with BG below 10.

The previous changes in the dose had been prescribed by the vet. The tricky part is, the "original vet" who's been seeing Siu Bo since he's a baby is currently on vacation and will be back only on the 22nd of September. Siu Bo has been diagnosed last Friday and he's been treated by the "visiting vet" since, the visiting vet's really helpful, as I brought Siu Bo to the clinic everyday since he's been diagnosed for blood test and check up. However yesterday was the visiting vet's last day, and now I have no one to seek advice.

Just now I called the clinic to confirm, the nurse advised that I should check Siu Bo's BG again at 08:00 tomorrow and follow the scale to decide on the dose, as the visiting vet has instructed that below 10, none, between 10 and 15, 1 unit, above 15, 1.5 units.

My apologise for my confusing message, English is not my first language and I'm really worried now.

Thank you again for your kind response.

I agree - no insulin with a BG this low. You've been told to use what we call a "sliding scale" for dosing. There are some people who do that but the recommendation we always make here is to give the same dose AM and PM unless the pre shot BG test gives a result that's too low. Lantus is a depot insulin and that depot acts like a time release mechanism. Changing doses too much can interfere with the depot and cause erratic BG levels.

I understand that it's difficult to get different advice from different vets and now you're reading something else again from someone on the internet. We have all gone through that confusion. All I can do is try to reassure you that the level of expertise here in dealing with feline diabetes is very high. I suggest that, as a first step, you set up the spreadsheet and go put a post on the Lantus forum asking for people to look at it.

Please don't apologize for your English. It's very good and your message is very clear.

 

[Mandy Lai]

I agree - no insulin with a BG this low. You've been told to use what we call a "sliding scale" for dosing. There are some people who do that but the recommendation we always make here is to give the same dose AM and PM unless the pre shot BG test gives a result that's too low. Lantus is a depot insulin and that depot acts like a time release mechanism. Changing doses too much can interfere with the depot and cause erratic BG levels.

I understand that it's difficult to get different advice from different vets and now you're reading something else again from someone on the internet. We have all gone through that confusion. All I can do is try to reassure you that the level of expertise here in dealing with feline diabetes is very high. I suggest that, as a first step, you set up the spreadsheet and go put a post on the Lantus forum asking for people to look at it.

Please don't apologize for your English. It's very good and your message is very clear.

Thank you very much for your kind advice. I'm feeling much more at ease now (thank you thank you!). I've already set up Siu Bo's spreadsheet, will post it to the Lantus forum after reading the forum essentials.

Thank you again!