Newly Diagnosed Cat Won't Eat or Drink

[sugar_rush]

After Kiwi's glucose curve 5 days ago, we were told to raise his dosage of Lantus to 3 units twice a day. For the last 2 days he has been barely drinking and eating about a quarter of his daily intake of food. We tested his BG 9 hours after giving him the 3 units this morning. It was 413. We really don't know how to help him at this point. Everything we have done has been under the recommendation of our vet. We would appreciate any help! Thank you.

 

[JanetNJ]

After Kiwi's glucose curve 5 days ago, we were told to raise his dosage of Lantus to 3 units twice a day. For the last 2 days he has been barely drinking and eating about a quarter of his daily intake of food. We tested his BG 9 hours after giving him the 3 units this morning. It was 413. We really don't know how to help him at this point. Everything we have done has been under the recommendation of our vet. We would appreciate any help! Thank you.

How long ago was he diagnosed? How fast were these increases made? Sometimes too much insulin can look like not enough, and vets tend to raise in whole units which is too much.

What food are you feeding?

Did he have any ketones in the past?

 

[sugar_rush]

Diagnosed 14 days ago with a BG over 500. From then until 5 days ago, he was at 1 unit, twice daily.

We feed him a total of 2 cans of fancy feat classic, and 1/4 cup Purina DM dry food daily (fed twice a day).

14 days ago, he had ketones show up in urine at a reading of 1. We smelled ketones on his breath, which is why we took him to the vet the day he was diagnosed. Haven't detected anything on his breath since.

Since our initial post, he has eaten and drank water, but still not near his requirements. Also, we were told by the vet to cut his insulin if he doesn't eat full meals, so as a result, we only gave him 1 unit of Lantus tonight.

 

[Tracey&Jones (GA)]

That sounds like some very quick dose changes. Lantus works best when given in a consistent manner. You may want to read the sticky notes in the Lantus forum. Too much insulin may look like not enough insulin.

Are you home testing? The other thing with Lantus isn't how high the preshot numbers are it is how low is the dose taking them.

You may want to start home testing and go back to a lower dose like 1 unit. Hold it for a week and then increase .25 units at a time.

Again go check out the sticky notes..and post back with any questions you may have.

 

[Golden_CatChild]

Hi Sugar Rush,

It sounds like you are doing a great job.

My cat was diagnosed in May and seems to be going into remission. He has some similar food issues and food amounts you mentioned. So I'll tell you my experience w him.

My cat has always been a finicky eater. And we worked to have him eat 1/3 a cup of dry or 1/2 a cup of canned Fancy Feast, or any combo of these (to equal about 1/3 a cup of dry). Do you try to exercise him? I take my cat on walks and I'm convinced this helped lower his blood glucose. He's always liked to go on walks on a leash, but if your cat does not, maybe try playing with him with a fishing pole toy (its a long stick w a toy on the end)? Does he like playing with those? I'd suggest trying to play with him for 15minutes twice a day. This also might increase his appetite. I was told exercise would not impact my ct. However exercise has been proven in humans to lower blood sugar levels and also helps the body use insulin better.

Do keep us updated!! It is hard when starting out. Very stressful, concerning and can be frustrating. But it sounds like you are doing a great job!!!

 

[Golden_CatChild]

Also 413, 8 hours after insulin, and being new to insulin, makes sense.

I think raising the insulin level seem to be a good idea (as your doctor prescribed), to get him down from 413. But that does seem like an ok number for him to have w/ being new to insulin, and at 8 hours after his shot.

If he eats half of his proper portion, I'd give him half his insulin amount.

 

[sugar_rush]

That sounds like some very quick dose changes. Lantus works best when given in a consistent manner. You may want to read the sticky notes in the Lantus forum. Too much insulin may look like not enough insulin.

Are you home testing? The other thing with Lantus isn't how high the preshot numbers are it is how low is the dose taking them.

You may want to start home testing and go back to a lower dose like 1 unit. Hold it for a week and then increase .25 units at a time.

Again go check out the sticky notes..and post back with any questions you may have.

Yes, we just started home testing today. We thought he might not have been adapting well to the new dosage also.

I gave him 3 units Friday night and he only had about 1/3 of his meal. He wasn't doing well today. I won't make that mistake again!

We will have to check out those notes.

Thanks so much for the feedback!

 

[sugar_rush]

Hi Sugar Rush,

It sounds like you are doing a great job.

My cat was diagnosed in May and seems to be going into remission. He has some similar food issues and food amounts you mentioned. So I'll tell you my experience w him.

My cat has always been a finicky eater. And we worked to have him eat 1/3 a cup of dry or 1/2 a cup of canned Fancy Feast, or any combo of these (to equal about 1/3 a cup of dry). Do you try to exercise him? I take my cat on walks and I'm convinced this helped lower his blood glucose. He's always liked to go on walks on a leash, but if your cat does not, maybe try playing with him with a fishing pole toy (its a long stick w a toy on the end)? Does he like playing with those? I'd suggest trying to play with him for 15minutes twice a day. This also might increase his appetite. I was told exercise would not impact my ct. However exercise has been proven in humans to lower blood sugar levels and also helps the body use insulin better.

Do keep us updated!! It is hard when starting out. Very stressful, concerning and can be frustrating. But it sounds like you are doing a great job!!!

Thanks so much for the support! I'm so glad you and your cat are doing well.

Never considered exercise before. He used to love playing with his feathered toys attached to a stick with a string, but he's seemed less interested over the last year or two. We will have to try playing more.

 

[sugar_rush]

Also 413, 8 hours after insulin, and being new to insulin, makes sense.

I think raising the insulin level seem to be a good idea (as your doctor prescribed), to get him down from 413. But that does seem like an ok number for him to have w/ being new to insulin, and at 8 hours after his shot.

If he eats half of his proper portion, I'd give him half his insulin amount.

Good advice. When we spoke to our vet this afternoon, he said dose him in proportion to how much he eats per meal. Wish he told us this sooner in order to avoid the mistake I made of giving him too much insulin after eating a small amount and having him suffer today lol.

We appreciate your feedback!

 

[Golden_CatChild]

Good advice. When we spoke to our vet this afternoon, he said dose him in proportion to how much he eats per meal. Wish he told us this sooner in order to avoid the mistake I made of giving him too much insulin after eating a small amount and having him suffer today lol.

We appreciate your feedback!

You are so welcome!!

Basically high numbers are not that dangerous (over long periods is where they can cause problems). But what is REALLY dangerous is the low numbers.

Low numbers happen by giving insulin without food. DO NOT GIVE YOUR CAT INSULIN WHEN THEY DID NOT EAT. Much better to skip a shot, then give a shot without food. Skipping a shot when without food is what your cat's body needs, as it hasn't eaten enough to need insulin to break down the glucose in its body (cause without food, there is no glucose in need of being broken down).

High levels are not life threatening (not immediately, but in long run over weeks would be), low levels, caused by giving insulin when without food (or too much insulin) can cause seizures, coma, permanent brain damage, and death. If you accidentally give insulin when the cat did not eat enough food RUB HONEY OR SYRUP (or sugar water in worst case you dont have either) on cats gums to up sugar level. If you do this right away, kitty should have a quick good recovery (no brain damage etc), but will need to be taken to ER right away.

Be sure to keep honey or corn syrup in the house at all times. Some honey or corn syrup can save your cats life. It has saved my cat's life.

So sorry to hear kitty suffered today!! Your doc really should have informed you better.

Dont be too hard on yourself for accidentally giving kitty the wrong amount earlier!! Us cat owners are not doctors. The diabetes world can be very overwhelming to get into for someone not medically trained and with little information.

 

[JanetNJ]

@Chris & China could use Lantus dosing advice here

 

[JanetNJ]

Diagnosed 14 days ago with a BG over 500. From then until 5 days ago, he was at 1 unit, twice daily.

We feed him a total of 2 cans of fancy feat classic, and 1/4 cup Purina DM dry food daily (fed twice a day).

14 days ago, he had ketones show up in urine at a reading of 1. We smelled ketones on his breath, which is why we took him to the vet the day he was diagnosed. Haven't detected anything on his breath since.

Since our initial post, he has eaten and drank water, but still not near his requirements. Also, we were told by the vet to cut his insulin if he doesn't eat full meals, so as a result, we only gave him 1 unit of Lantus tonight.

Thank you for getting back with all that info.

1 unit was the correct starting dose, but 3 units is more than many cats ever need. Raising the dose by two units was a dangerous move. It is recommended you increase lantus by no more than 0.25-0.5 units at a time. So if 1 wasn't enough than the next dose to try would be 1.5. To high of a dose can cause two outcomes. Hypoglycemia.... The blood glucose dropping to dangerous lows... This can be fatal!!! Sometimes too much insulin can look like not enough because the body is trying to protect itself from crashing and so it is releasing stored glucose resulting in a high bounce.

Don't rely just on smell to know if your cat had ketones. You can get ketone reading strips in any pharmacy. You collect a bit of urine either by putting the strip in the stream, collecting with a ladel or put a little plastic wrap and bunch it in the litterbox where he goes. If the strip reads anything above trace go immediately to the vet.


Fancy feast classic is a great food. Skip the dm.... It's way too high in carbs. You need to keep carbs under 10%.


So glad to read you are home testing!!!!! This is going to be your number one tool. So try to get a preshot number each time. So be sure he's not had any food for at least two hours prior to the preshot test. You will want to test, then feed, then shoot in that order.

Them when you can, get some mid cycle readings.

Lantus works best when dosed consistently.... But I feel you are giving way way too much for a newly diagnosed cat.

Go to our lantus forum and read the yellow stickies at the top that describe two dosing protocols. See which you are more comfortable with.

Here's a link to the spreadsheet you see in our signatures. If you need help setting it up just ask and someone can help set it up for you.

 

[sugar_rush]

Thanks for the tips guys!

Kiwi was eating well last night, so we gave him one unit of Lantus. He won't eat anything this morning, but he is drinking again. His BG is now 553, 12 hours after last injection.

Vet is recommending anti-nausea med Cerenia to get him to eat. He's worried Kiwi may have pancreatitis, causing him to be nauseous and not eat...

 

[JanetNJ]

Thanks for the tips guys!

Kiwi was eating well last night, so we gave him one unit of Lantus. He won't eat anything this morning, but he is drinking again. His BG is now 553, 12 hours after last injection.

Vet is recommending anti-nausea med Cerenia to get him to eat. He's worried Kiwi may have pancreatitis, causing him to be nauseous and not eat...

There's a test called a snap test to check for pancreatitis. It's not expensive and can be done right in the vet without being sent out. Pancratitis is painful... If that's what it is the usual treatment is cerenia, sub q fluids, and a pain killer such as bupe. My cat zim had it, and we started those treatments early, so he was able to recover at home in about 5 days... but some cats totally lose their appetite and need hospitalization.

 

[JanetNJ]

When you get a chance set up a signature. Click on your name at the top right corner and choose signature. Add info such as your pets name, date diagnosed, insulin type and dose, food you're feeding,and anything else you want to add such as s other health concerns and whether your cat had had issues with ketones.

 

[Larry and Kitties]

There's a test called a snap test to check for pancreatitis. It's not expensive and can be done right in the vet without being sent out.

The Snap test is not 100% accurate and you only get a yes/no result. When Idexx (or TAMU) does the test you get a numerical value

 

[sugar_rush]

Just an update: Kiwi has stopped eating altogether in the mornings, although he does consume 1/4-1/2 of his daily intake in the evening/night time. He is still drinking. We have done pre-shot, 4 hour, and 8 hour tests, his BG is always between 400-600. We have reduced his shots to either 1 or 2 units depending on how much he eats. We are in the process of obtaining Cerenia in the hope that it helps him to eat more. We fear he has pancreatitis, but we are having problems getting his BG under control.

How good is the fPLI blood test? This is the one our vet recommended should we get to that point.

 

[Tuxedo Mom]

Just an update: Kiwi has stopped eating altogether in the mornings, although he does consume 1/4-1/2 of his daily intake in the evening/night time. He is still drinking. We have done pre-shot, 4 hour, and 8 hour tests, his BG is always between 400-600. We have reduced his shots to either 1 or 2 units depending on how much he eats. We are in the process of obtaining Cerenia in the hope that it helps him to eat more. We fear he has pancreatitis, but we are having problems getting his BG under control.

How good is the fPLI blood test? This is the one our vet recommended should we get to that point.

The fPLI test is very accurate for diagnosing pancreatitis and will give a numerical reading as to how high it is. My GA kitty had chronic pancreatitis. He was a total food pig so when he would not completely clean his food there was reason to be concerned. During his 2 1/2 years he had 4 pancreatic flares, which were dealt with using Cerenia for the nausea, buprenorphine injections for pain control ( injections are better if the kitty is throwing up) and Sub Q fluid for hydration. I would definitely get the fPLI test done to find out if this is the problem. Good luck

 

[sugar_rush]

Finally got Kiwi's BG under control for the moment. He is now getting 15mg of Cerenia for nausea per day and is eating again! We gave him 2 units of Lantus Monday night and Tuesday morning, and measured his 8 hour BG to be 214!!! This is major progress! We will have to give him the anti-nausea meds so he continues eating normally, we fear. Going to do fPLI blood test for pancreatitis soon.

 

[Chris & China (GA)]

Great to hear he's eating better!!!

Can we get you to go ahead and start our spreadsheet? We are very data driven here and having the spreadsheet will really help us give you better advice. Here are Instructions on getting the FDMB spreadsheet

If you have any problems I'd be happy to help you. Just send me a private message by clicking on my name and choosing "Start Conversation"

 

[Meya14]

Please get ketone test strips and do a test ASAP. Poor appetite in a newly diagnosed cat is number 1 sign of ketones. Ketones can progress into serious illness very rapidly, and steps can be taken to avoid this if caught early. Also yes, low blood sugars are dangerous, however, if your pre-shot blood sugars are high you can probably give at least a partial dose. Lantus doesn't really begin working for hours later so you have plenty of time to get food into the kitty. Withholding insulin can increase the likelihood of ketones and progression into DKA.