? Low BG numbers = really low appetite?

[shelaghc]

I'm seeing a scary pattern with Jester.
Whenever his BG goes down to a healthier range, his appetite goes *way* down.

The last couple of days his BG has been in the 200s / 300s and he's been eating like a champ. (Turns out he may not have been actually getting insulin - but that's another story.)

This morning he's back in the mid-100s and feeding him is miserable. I put down the dish, he munches for a couple of minutes, then turns away. I scoop the food around the plate, more munching, then turning away.

The pattern can go on for an hour. (It's almost a relief that I lost my job.)

And before anyone asks, no - fortiflora doesn't seem to have any effect on his appetite.

His weight is frighteningly low. I'm almost tempted to not give him any insulin this morning just so he'll eat more this evening.

Has anyone else had experiences like this dealing with appetite and lower BG? As I recall, when he stopped eating entirely back in late July he also was going into remission. I had to give him high carb foods and dry stuff before he would eat on his own.

 

[shelaghc]

With no guidance at all and Jester still working on the same bowl of food for over two hours now, I just decided to skip his insulin this morning.

 

[Veronica & Babu-chiri]

When a cat is unregulated and specially in high numbers he will most likely be very very hungry, but that is not necessarily good, thing is insulin is what allows the cells to use the nutrients, without it or not enough of it like with unregulated diabetes, cells do not get the nutrients, and keep asking for them so the cat is always hungry because even though he is eating he is not able to actually use the food properly, once they start getting low numbers they usually start to eat a little bit less, once regulated he will probably regain some weight but it will take time. (still you have to be careful because not eating could be a sign of a different problem or illness).

Also when they are new to low numbers they have a tendency to act a little bit down, is like their body had got accustomed to function on high numbers and the low even if it is not too low or dangerously low just lower than they usually had so getting low makes them feel not too good at first .

 

[shelaghc]

He's not acting a little bit down. This isn't eating a little bit less. He stops eating almost entirely. It took me nearly three hours to get him to eat 2/3rds of a can of food. And that was with constant coaxing.

He wasn't walking away from the bowl, he sat in front of it like he wanted to eat. But I had to play with the food, heat it up, change bowls, move it around in the bowl some more, over and over and over and over again - all between 7:30 and 10:30.

Right now he's in the dining room waiting for me to come out and do the same dance some more. If I open a new can of cat food, he's more likely to eat that. But there are no guarantees.

When he went into remission a few months ago, I had to syringe feed him. I finally tried a little dry food and he ate that. Then the only things he would eat were high carb foods and he went out of remission.

All of this, with notes, is in my spreadsheet.

When I posed the question here, no one responded even though several people looked at the post. I had to make a decision without any guidance at all.

If I gave him insulin now, it would be four hours late.

I've also been told that you can't give insulin to a cat who hasn't ingested anything. Considering the length of time it took me to get him to eat anything of substance, it still would have been at least two hours late and I've been told by people here that it's better to skip a shot than give it to him two hours late.

 

[Tracey&Jones (GA)]

I am sorry you didn't get guidance when requested. I think you did the right thing. It was the safest approach.

The funny thing with Jones - he doesn't eat when his numbers are higher. He eats better when they are lower.

I am wondering if Jester may have acidic tummy. Is he licking his lips at all? Any clear foamy vomit?

 

[Elizabeth and Bertie]

I've also been told that you can't give insulin to a cat who hasn't ingested anything. Considering the length of time it took me to get him to eat anything of substance, it still would have been at least two hours late and I've been told by people here that it's better to skip a shot than give it to him two hours late.

That advice is 'general advice' where the circumstances of the cat aren't known in any detail; but it is usually the 'safest' option in many situations.

There are situations however where it is advisable to give 'some' insulin (maybe a reduced dose) even if the cat hasn't eaten; for example, if there's been a DKA diagnosis (or ketones are present) and so long as you'll be around to monitor the kitty's BG; or if the BG is very high. And there are also situations in which it's OK to give a late shot (for example, if you're also able to delay the following shot).
But these things are entirely dependent on your own cat's specific situation, and your own level of experience in managing any course of action. If someone here doesn't know your cat's history (or your experience level) they will probably go with 'general' advice.
.

 

[CassWTribby]

Staring at food and not eating plus the eating a bit then stopping could mean he's nauseas. Does he have any other symptoms like vomiting or diarrhea? is he drooling?
A safe treatment for hairball, nausea and any gastro issues is slippery elm gel or powder. It coats the stomach and bowel and is safe. You have to give it seperate from any oral meds though as it can block absorption. Also ask your vet about maybe trying an acid reducer. There are several Otc that are safe for cats. If his kidneys are affected by his diabetes this can cause an acidic tummy. You can also try some appetite stimulants once you have ruled out nausea. there is lots of info about slippery elm on IBD Kitties webpage.
When my cats #'s are low she's starving! Every cat is different. It's hard to treat them!

 

[Veronica & Babu-chiri]

He's not acting a little bit down. This isn't eating a little bit less. He stops eating almost entirely. It took me nearly three hours to get him to eat 2/3rds of a can of food. And that was with constant coaxing.

He wasn't walking away from the bowl, he sat in front of it like he wanted to eat. But I had to play with the food, heat it up, change bowls, move it around in the bowl some more, over and over and over and over again - all between 7:30 and 10:30.

Right now he's in the dining room waiting for me to come out and do the same dance some more. If I open a new can of cat food, he's more likely to eat that. But there are no guarantees.

When he went into remission a few months ago, I had to syringe feed him. I finally tried a little dry food and he ate that. Then the only things he would eat were high carb foods and he went out of remission.

All of this, with notes, is in my spreadsheet.

When I posed the question here, no one responded even though several people looked at the post. I had to make a decision without any guidance at all.

If I gave him insulin now, it would be four hours late.

I've also been told that you can't give insulin to a cat who hasn't ingested anything. Considering the length of time it took me to get him to eat anything of substance, it still would have been at least two hours late and I've been told by people here that it's better to skip a shot than give it to him two hours late.

I'm sorry you didn't got an answer on time this is a very busy time of the year.

I don't have experience with prozinc so I'll leave that part to the experts.

But this does seem like it is not necessarily related to the insulin, has he been tested for ketones?

Playing or just staring at his food and not eating sometimes is a symptom of stomach acid (gastritis) has he been tested to see how are his kidneys.? Is he pooing ok or is he constipated? Does he had any vomiting?

 

[Juliet]

Suggestion if you’re not getting a response. Type a new comment and say bump. Just to get it at the top of the thread again.

 

[shelaghc]

I am sorry you didn't get guidance when requested. I think you did the right thing. It was the safest approach.

The funny thing with Jones - he doesn't eat when his numbers are higher. He eats better when they are lower.

I am wondering if Jester may have acidic tummy. Is he licking his lips at all? Any clear foamy vomit?

He has has some foamy vomit off and on. I think that happened this morning or yesterday morning.

This is the first I've known that could be an issue.

 

[shelaghc]

Playing or just staring at his food and not eating sometimes is a symptom of stomach acid (gastritis) has he been tested to see how are his kidneys.? Is he pooing ok or is he constipated? Does he had any vomiting?

My money is very tight and the vet isn't always willing to let the costs involved with testing slide. He's fine in the litterbox, although he had diarrhea about a week ago right. That was most likely due to him eating a huge amount of a cat food he's not as used to.

 

[shelaghc]

Playing or just staring at his food and not eating sometimes is a symptom of stomach acid (gastritis) has he been tested to see how are his kidneys.? Is he pooing ok or is he constipated? Does he had any vomiting?

Jester hasn't been playing with his food. I kind of have to play with it to get him interested in it.

 

[Veronica & Babu-chiri]

I'm just guessing but it does seem like he has some digestive problems, some of the things you've mentioned do suggest that, little foamy vomit ( this is usually because they have to much acid in their stomach ) definitely not normal, just looking at his food and maybe eating after you insist , some mild diarrhea, you could try giving him something like SEB (slippery elm bark ) or raising his food bowl.

I'm not saying he has kidney problems, but this is a page that has a lot of information related Gastrin (Excess Stomach Acid) and to some of the symptoms you are mentioning and with some suggestions on how to treat them http://www.felinecrf.org/nausea_vomiting_stomach_acid.htm



Are you monitoring him for ketones?

 

[Tracey&Jones (GA)]

This is the first I've known that could be an issue.

It can be. I see that type of eating behaviour with Jones and my KD kitty. I make sure they get some freeze dried treats. Sometimes that is all Jones will eat outside a few bites of food. Then 20 minutes later go goes and eats.

I have ended up using the famotidine (liquid Pepcid) but both of the kitties fight that, so I use it as a last resort.

 

[ZulusMom (GA)]

At 149 without eating I think no shot was a good call. I'm not sure how it would affect appetite, but I see a couple of days ago he went from 181 to 338 - maybe a bounce from going too low during the day. If possible, try to get a mid-cycle number the next time he's at a high enough pre-shot number to give insulin - it might be that he's due for another dose reduction.

 

[shelaghc]

At 149 without eating I think no shot was a good call. I'm not sure how it would affect appetite, but I see a couple of days ago he went from 181 to 338 - maybe a bounce from going too low during the day. If possible, try to get a mid-cycle number the next time he's at a high enough pre-shot number to give insulin - it might be that he's due for another dose reduction.

TBH I think there's a possibility Jester wasn't getting any insulin for a couple of days.
The vial is nearly empty and my eyes aren't the greatest for seeing small things - even with reading glasses on.

I kept thinking the liquid in the syringe looked really clear instead of the slightly opaque it usually is.

Since last night, I've been tilting the vial and the opaque liquid is showing up again.
And, even with Jester eating pretty much all carby food, his BG went down with just last night's shot.

 

[shelaghc]

And BG wasn't even all that bad this evening after no insulin this morning - still under 300 even after eating about 3/4 a can of medium carb food.

 

[shelaghc]

BG back in the mid-150s.

When I was filling the syringe this morning, I brought it over to a strong light and could clearly see the tip of the needle sticking out of the insulin.

I'm amazed Jester's BG wasn't way higher under the circumstances.

 

[ZulusMom (GA)]

I don't mean to sound like a broken record (if I come off that way, I really do apologize - the past 24 hours have been miserable, and coffee alone is keeping me going at this point), but please try to get a mid-cycle reading if possible. 156 is a nice, blue number, you just want to make sure it's safe to shoot a full unit when the pre-shot is that low. It looks like Jester's pancreas is starting to wake up.

 

[shelaghc]

I don't mean to sound like a broken record (if I come off that way, I really do apologize - the past 24 hours have been miserable, and coffee alone is keeping me going at this point), but please try to get a mid-cycle reading if possible. 156 is a nice, blue number, you just want to make sure it's safe to shoot a full unit when the pre-shot is that low. It looks like Jester's pancreas is starting to wake up.

Today won't be the day to do this, unfortunately. I have a doctor's appointment at 11:00 and likely won't be home until nearly 2:00.

Since I have to leave by about 10:30, that's too early for mid-range, and unless I get home sooner, I'll be too late for mid-range.

 

[shelaghc]

Talked with one of the vets and she wants me to give Jester 1/2 of a 10mg pepcid before bed for about a week.

Crossing my fingers that this makes the difference.

 

[shelaghc]

@ZulusMom
Any time you want to make like a broken record with me, do it.
Finally did a mid-cycle a few minutes ago and Jester's BG is 53!

ACK!

Vet said to feed him as much as he'll eat for now. She doesn't like giving honey or sugar water and having his BG spike.

Supposed to check again in an hour, then again tonight and lay off any insulin at all tonight.

I was on my way out the door, originally. Not now. No way. Staying home until he's doing at least a little better.

 

[ZulusMom (GA)]

Yikes! So glad you were able to catch it and that you can stay with him! You might want to ask around in the ProZinc forum, but I'd say he's earned a dose reduction going forward. Fingers (paws?) crossed, he might be heading towards remission.

 

[shelaghc]

Yikes! So glad you were able to catch it and that you can stay with him! You might want to ask around in the ProZinc forum, but I'd say he's earned a dose reduction going forward. Fingers (paws?) crossed, he might be heading towards remission.

He went into remission once before.
I'm wondering if he's going to be on and off of insulin on a regular basis.

First time on remission, he stopped eating for nearly two weeks and scared the crap out of me. (See the notations on 8/21 in Jester's spreadsheet).
So far he's still eating and well. I haven't been pushing for him to eat low carb foods, just keeping him on medium carb for the time being.

 

[shelaghc]

Update: His BG is already back up to 98 after eating over half a can of medium carb canned food.

Phew!