? HELP! Oscar not eating, acting unwell, unsure what to do about shot

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I agree with Wendy, you need cerenia or ondansetron for nausea.
Can you update the SS please when you get time thx?
That’s good he’s drinking on his own.
You are doing well.
 
Okay, got a ketone test in. At 80 :/ so still way too high. He's drinking a lot of water, but should I move up his subq fluids to tonight or should I wait until tomorrow like I was told?
 
Bron and Sheba (GA) said:
I agree with Wendy, you need cerenia or ondansetron for nausea.
Can you update the SS please when you get time thx?
That’s good he’s drinking on his own.
You are doing well.
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The vet keeps telling me he isn't showing signs of nausea...so they didn't give me any.

Was also told the antacid should help with that anyways?
 
Mimis mom said:
When Mimi was in the hospital for DKA they gave her short acting insulin- it was not an option I guess? What’s his BG been??
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They gave him short acting in the ER, but at home they want him on his ProZinc... probably because they don't want him dropping too low
Bg has been going up...but during the height of his sickness it was staying low even without insulin, so vet was hoping that's actually a sign he's doing a little better and now we just have to keep raising his dose back to normal as long as he doesn't drop too low. He's been hanging out in the mid 200's today, going to update my SS as soon as I charge my phone
 
The first day back home after whatever episode can be a little tough. You have people giving advice re: the recent DKA with which I don't have direct experience, but :bighug::bighug: for you, please know you are doing a terrific job, and keep us posted, okay?
 
Chloe007 said:
The vet keeps telling me he isn't showing signs of nausea...so they didn't give me any.

Was also told the antacid should help with that anyways?
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sniffing the food and walking away is a classic sign of nausea. Cats that are nauseated won’t eat. You know yourself, if you are nauseated you can’t eat.
I would go back to the vet and ask for both cerenia and ondansetron....don’t leave without it. Make a fuss if necessary. Most cats post DKA have some degree of nausea.

Chloe007 said:
Okay, got a ketone test in. At 80 :/ so still way too high. He's drinking a lot of water, but should I move up his subq fluids to tonight or should I wait until tomorrow like I was told?
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Yes 80 Mg/dl is too high. We need to get that down.
Do you think you can increase the food a bit. But we don’t want to make him sick. Getting the antinausea meds is key to getting him to eat so do that ASAP.

I think 50 ml a day subQ is better than 100 alternate days. Did you say how much he weighs?.
I’d like to hear what @Wendy&Neko thinks about giving 50 mls fluid daily instead of 100 mls alternate days before you give any though.
 
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Chloe007 said:
The vet keeps telling me he isn't showing signs of nausea...so they didn't give me any.
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Is Oscar showing any of these signs of nausea?
Lack of appetite, refusing to eat on his own
Licking of lips repeatedly
Excessive chewing of food
Restlessness, anxiousness
Drooling or excessive swallowing
Excessive meowing
Dry heaving
Vomiting

You are there observing Oscar and may pick up on some of these symptoms your vet overlooked.
I'm with Bron and Sheba. Get your vet to give you anti-nausea meds for Oscar. The weekend is coming and the vet might be closed.
 
Deb & Wink said:
Is Oscar showing any of these signs of nausea?
Lack of appetite, refusing to eat on his own
Licking of lips repeatedly
Excessive chewing of food
Restlessness, anxiousness
Drooling or excessive swallowing
Excessive meowing
Dry heaving
Vomiting

You are there observing Oscar and may pick up on some of these symptoms your vet overlooked.
I'm with Bron and Sheba. Get your vet to give you anti-nausea meds for Oscar. The weekend is coming and the vet might be closed.
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The ER he was treated at is 24/7 so I at least don't need to worry about not getting any, I'm calling them soon about his insulin dose and will ask to pick up the anti nausea meds when I do. His feeding is coming up in a half hour though, I should be giving him his stimulant now. Should I hold off giving him that without the anti nausea med? And then I'll have it for tomorrow morning?
 
If he is willing to eat, I'd go ahead and feed him.

Have you done the "skin tenting" trick to check Oscar for dehydration?
Or checked his gums? Are they sticky and tacky?
 
I wouldn’t give the appetite stimulant without giving the antinausea first and time to work.
But still continue to syringe feed him. He needs to eat. It will be much more pleasant for him if you can get rid of the nausea.
Also here in Australia we have to get the ondansetron from a pharmacy as it’s a human medication. Not sure how it works over there in the US but you may need to get a script from the vet and then get the ondansetron from the pharmacy.
 
Reminder to give the subq fluids and the insulin shot, as far apart in different areas of the body as you can.

The fluids can interfere with the absorption of the insulin, if the injection spots are too close together.
 
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Deb & Wink said:
If he is willing to eat, I'd go ahead and feed him.

Have you done the "skin tenting" trick to check Oscar for dehydration?
Or checked his gums? Are they sticky and tacky?
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I fed him, he spit a lot up a first but I think I got my technique down better and I feel confident he will have at least a full can of recovery food in him by the end of the night.
I didn't give the appetite stimulant for fear it would make nausea worse, I'm not actually noticing any obvious signs of nausea like you listed, but he has moments where it looks like he might so I called the ER and we're going to pick up some Cerenia.
Dehydration signs look okay, skin snaps back as I assume it should, gums are maybe a bit tacky but they're pink and turn pink again once blanched. He hasn't drank much in the past couple hours, however he was at his water bowl over and over again earlier. Keeping his water fresh with ice cubes etc.
I called and asked about subq fluids tonight or waiting until tomorrow and I'm waiting to hear back from the doctor about that.
 
I'm starting to update his SS/labs. He has two sets of blood work...actually maybe three I'll have to look. Should I do all of them or is only the most recent relevant?
 
You might want to try squirting some water into his cheek pouches.
A little at time and make sure he swallows it.

SS updates first please, then labs.
 
He seems nauseated, still waiting for doctor to call us to OK us to pick up Cerenia. Will probably have to wait until morning at this point..
I think I got about a whole can of food in him today, I'm going to give him a little longer before I try feeding again (been two hours since I got about 30ml food into him) so that he doesn't throw up. Plus he's really tired right now. He's been getting his feeding, antibiotic and shot all at once and I think it takes a lot out of him. He looks like he's sleeping soundly and out of pain, so I'd like to let him rest a while. Once he wakes up I'll do another feeding.
I have his SS update from today- I don't yet have glucose readings from the hospital put in because it's difficult to decipher all the info, it'll take me a bit. Same with the labs.
 
Deb & Wink said:
You might want to try squirting some water into his cheek pouches.
A little at time and make sure he swallows it.

SS updates first please, then labs.
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I tried doing that when I gave him his last pill because he has trouble swallowing...he really didn't like it. He drank some water a bit ago and is resting soundly now, doesn't seem to be in pain so I think I'll give him some time before I try syringing anything again. I'm worried he may be nauseated too, so I don't want to overdo things until I get his Cerenia.

SS updated from today- hospital readings may take a bit longer because they're hard to decipher when they happened etc. Labs will be a little bit too. I'm going to get some rest while he's resting and after I feed him in a little while I'll get back to updating everything else.
 
Vet still hasn't called me back about whether or not to do fluids tonight. They did 50ml last night to show me, and I'm supposed to do 100ml every other day. But I'm not sure if that counted yesterday or not, so I don't know if I should do tonight.

He's been drinking some water, BG went up just now but I did just feed him (didn't end up taking that nap lol) so I'm hoping that means I got some food into his system? Idk. When I sent the vet his readings today they told me to keep him at 4u. What do you guys think? His dose prior to diagnosis was 5.75 but then went down to 3 because the sicker he got, the lower his BG got and didn't take nearly as much insulin to maintain. Everything from today on SS is up to date except last reading just now (9:05pm, +3) which was 327
 
Thanks for getting another ketone test in.
I’m not a Prozinc user so I’m not sure what to advise about the dose. We need to get those ketones down though.
Not sure if @Wendy&Neko is around at the moment. I’ll tag @Sandy and Black Kitty as well.
I think you could do 50 mls a day instead of 100 mls alternate days.
Let’s see if Wendy or Sandy come on line soon. We have several hours to the next dose is due. Keep offering food or syringe feeding. When can you pick up the cerenia?
 
If Oscar doesn’t have a history of heart issues, I’d give 100 ml of fluids tonight. The ketones need to be flushed and he needs all the help he can get. I didn’t catch his current weight but it’s generally not uncommon to give 100ml daily in ill cats.

Just my two cents. I’m heading back into the woodwork now. :-)
 
Bron and Sheba (GA) said:
Thanks for getting another ketone test in.
I’m not a Prozinc user so I’m not sure what to advise about the dose. We need to get those ketones down though.
Not sure if @Wendy&Neko is around at the moment. I’ll tag @Sandy and Black Kitty as well.
I think you could do 50 mls a day instead of 100 mls alternate days.
Let’s see if Wendy or Sandy come on line soon. We have several hours to the next dose is due. Keep offering food or syringe feeding. When can you pick up the cerenia?
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Thank you, as always. The vet got back to me before I seen this and I have him the 100ml per their instruction, but can/will do the 50ml everyday instead from here out. I totally botched it. The needle came out and sprayed everywhere, so I went back in and I guess I made too big a hole because he started leaking after. He still had a big bolous spot near his neck so I'm sure he got the majority...but the whole thing freaked me out.
I last got 15ml of food into him about an hour ago, probably about 90ml so far for the day.
He's pretty lethargic after the fluids, I think it stressed him.
I'm going to try to feed him again at 12 since that's when his antacid is due
 
JL and Chip said:
If Oscar doesn’t have a history of heart issues, I’d give 100 ml of fluids tonight. The ketones need to be flushed and he needs all the help he can get. I didn’t catch his current weight but it’s generally not uncommon to give 100ml daily in ill cats.

Just my two cents. I’m heading back into the woodwork now. :)
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Thank you, I was thinking the same thing. I gave him the 100ml, he's 13lbs. I pretty much all but botched it..so I'll probably do again tomorrow if everyone thinks that's okay.
 
Don’t worry about the first time. It runs in pretty quickly. I’m glad he got some fluids in. He must be exhausted. You too. Try and rest when you can. The sack of fluid will stay there for several hours as it’s absorbed so don’t worry . It will gradually go down.
You are doing a fantastic job looking after him!:bighug:
 
Chloe007 said:
I'll probably do again tomorrow if everyone thinks that's okay.
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I would if it were my cat. In fact I’d do it again tomorrow even if it wasn’t “botched,” as well as the day after that.

What gauge needle are you using for the fluids? I usually use 19 or 20 gauge, though others will work. The larger the gauge the faster the fluids run in, but sometimes the larger gauge needles leave bigger holes and are more likely to leak (plus are more noticed by the cat). I once had a vet give me 16 gauge needles — those were veritable harpoons!

Note that 18 gauge is “larger” than 20 gauge. The numbers seem backward, but the higher the number the smaller the needle.

Giving subQ fluids gets easier — you’ll get the hang of it.

edited to add: it’s always a good idea to check that the feet and legs aren’t “puffy” before giving the next round of subQs. That can be a sign that the fluids aren’t being properly absorbed and the overload has settled in the legs. (Just a best practice, not something you’ll probably have to worry about)
 
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JL and Chip said:
I would if it were my cat. In fact I’d do it again tomorrow even if it wasn’t “botched,” as well as the day after that.

What gauge needle are you using for the fluids? I usually use 19 or 20 gauge, though others will work. The larger the gauge the faster the fluids run in, but sometimes the larger gauge needles leave bigger holes and are more likely to leak (plus are more noticed by the cat). I once had a vet give me 16 gauge needles — those were veritable harpoons!

Note that 18 gauge is “larger” than 20 gauge. The numbers seem backward, but the higher the number the smaller the needle.

Giving subQ fluids gets easier — you’ll get the hang of it.

edited to add: it’s always a good idea to check that the feet and legs aren’t “puffy” before giving the next round of subQs. That can be a sign that the fluids aren’t being properly absorbed and the overload has settled in the legs. (Just a best practice, not something you’ll probably have to worry about)
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Yeah I just feel like considering he still has ketones, getting fluids everyday is important. That makes the most sense to me. I'll have to check and see what gauge they are, they seem huge to me. But that's exactly what happened with the leaking etc. Can I buy those needles OTC? Or would I need to get them from my vet?
Thank you much for the info!
 
I’m sorry I too have no experience with prozinc, I do however have experience with DKA. My BK was hospitalized twice. The second episode he went from negative to large in exactly 24 hours.

You see the way DKA works is that when there is not enough energy from food making it into the cells, the body will breakdown it’s own fat and protein to try and fulfill the need for more metabolic energy. The excessive breakdown of these stored reserves creates a toxic by-product - ketones. As ketones build up in the blood stream, the resulting pH and electrolyte imbalances can very quickly develop to life threatening levels , a state of DKA.

What sets the stage for ketone development is:
  • Not enough calories
  • Not enough insulin
  • Infection/inflammation/systemic stress
Eating is key. A kitty recovering from DKA should be consuming 1.5x the calories required to maintain ideal weight.

Hang in there and hang in here
 
Help;; Oscar is at 147 preshot...not sure how to proceed. He was in the mid 200's until just now, not sure why he dropped. Just fed him and going to check again in an hour (what vet said to do)
 
I’m sorry I’m no help with Prozinc but I know we don’t want to skip the shot with ketones still high.
Do you have some higher carb food you can syringe feed him to bring him up higher and then keep feeding the higher carb food?

How is the eating going? How much are you managing to get in?
Can you update the SS please?
Have you managed to test for ketones again?
 
Bron and Sheba (GA) said:
I’m sorry I’m no help with Prozinc but I know we don’t want to skip the shot with ketones still high.
Do you have some higher carb food you can syringe feed him to bring him up higher and then keep feeding the higher carb food?

How is the eating going? How much are you managing to get in?
Can you update the SS please?
Have you managed to test for ketones again?
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I believe I'm already feeding him higher carb food although I admit I haven't checked the count, I'll do it now. He's eating the royal canine recovery food. Should I have someone go grab some gravy food?
I managed to get about 25ml into him just now, I'm sure I could get him to take some more in a little bit he just doesn't like too much at once.
Updating now- boyfriend left with the phone that has all his libre info, but will be back in a minute so I'll have that info in a few minutes to update. (Basically all mid 200's up until +9 though when we took a nap until +11)
Yes I got a ketone test, it looks a bit lighter today. I'd say down a level (40 instead of 80)
 
Ok I just rechecked and he's up to 208 about 40 minutes later. I'm sure that's food influenced, but I feel like he probably needs his full dose so I'm going to go ahead and give his shot and monitor closely, as I have to anyways. Having boyfriend grab some gravy food just in case, and as always have Karo etc.
 
That’s good news that the ketones have dropped to 40!!
Yes I would get someone to get several cans of gravy lovers f f if that’s ok for him to eat.

Ok. Just seen above you posted and the BG is 208 and you are giving the full dose.
Yes it is food influenced but we have to do what we have to do to manage the DKA.
Continue feeding the gravy food, maybe mixed or alternate with a/d for the first few feeds at least of the cycle when the BG is likely to go down due to the influence of the insulin.
Get a +1 and +2 to start with and post results please.
It’s pretty late for me but I’ll watch til +1 at least.
 
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