10/12 Butters PMPS 288

Butters & Lyla

Butters & Lyla

Member Since 2020
Yesterday overnight there was really no change in Butters.:( I haven't see four of the 5 "P's": no peeing, pooping, preening or playing. She has done some purring, though, but not a content purr. I can't believe this is the same cat who was so frisky and playful all night Thursday. What happened in a day, Butters?

She still has pain face. She still sniffs all of the foods but doesn't eat. I left a food buffet out overnight and it was untouched.:( I offered her everything from my hand this morning and she didn't touch it. I gave her freeze dried chicken. She actually took that into her mouth for a few seconds and then let it fall out. She was also interested in tuna, chewed it but spat it out. :(

She is still twitching/tremoring. Also, her tummy feels quite hard.

Started ondansetron this morning.

I'm going to see if she will accept some syringe feeding, but my gut says if I have to force her then maybe I need to take her back for more help. That thought is very unappealing to me, though.

Have a great day, all! Kitties surf safe. And thank you for all of the support and thoughts and prayers.:bighug:
 
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Aww. Poor Butters. I was hoping for a bit better news for her. If you think you need to take her back to the vet, then that's probably the best thing for her. I don't have any experience with pancreatitis, so all I can offer is positive thoughts that she'll be feeling better soon. I know every minute seems like forever when they're in pain and you're worried about them. But with a little bit of time and alot of help, she'll feel better. :bighug: Hugs to you and Butters
 
Thank you Cheryl:bighug:
I don't want to rush back to the vet, that's for sure. If I can get more food into her I wouldn't rush back. And I just haven't had much luck at all finding a decent primary care vet in my part of Ontario.
 
What part of Ontario are you in, if you don't mind my asking. I'm in Windsor. Our vet is pretty decent. I do hope Butters ears something for you. A little bit at a time.
 
I'm so very sorry to hear she's still twitching and refusing food.

Timing on this is just awful :( I do hope some of the other Canadians can possibly make some suggestions for at least someone who might consult with you. I think my biggest worry would be dehydration...was she on an IV to at least get fluids when she was at the ER/hospital?

That may be a last ditch effort - at least to keep her hydrated...that cannot possibly help in this situation to allow her to become more dehyrated...

I'm so sorry Lyla...still sending strong prayers and get well vines to Butters :bighug::bighug::bighug:
 
I'm in Toronto. There are a lot of veterinary practices. I just haven't found a good one for her yet, it seems. And the vet I used for my previous cats, who was pretty great , has retired and sold her practice to a big corporation. It feels like a big money making business now.

Sue and Luci said:
I'm so very sorry to hear she's still twitching and refusing food.

Timing on this is just awful :( I do hope some of the other Canadians can possibly make some suggestions for at least someone who might consult with you. I think my biggest worry would be dehydration...was she on an IV to at least get fluids when she was at the ER/hospital?

That may be a last ditch effort - at least to keep her hydrated...that cannot possibly help in this situation to allow her to become more dehyrated...

I'm so sorry Lyla...still sending strong prayers and get well vines to Butters :bighug::bighug::bighug:
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I actually don't think anyone else is in Toronto. I have a vet reco from a member here a while back, but it is a far drive and butters gets super stressed in the car. However, that's probably the least of my concerns now. But there are plenty of vets I can call and interview in the city. I did that, and seem to keep getting duds. They know what to say and I guess I'm too trusting.
Right...the ER refused to send me home with subq fluids. She hasn't peed since she got home yesterday around 19 hours ago. Peed twice before I picked her up.
 
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Hugs to you and Butters :bighug: Hoping the meds help and she will start eating.

BTW, if you decide to go feeding tube route, Jax had one a few years ago. I could syringe food and meds down. After a few days of syringing food, he started eating on his own and then we kept it in for meds. He got his at our ER Vet and they gave us a cute Kitty Kollar to keep the tube in place. I know you've been reading all the things but Dr. Lisa has a nice article on feeding tubes that may help incase you talk about it with the vet - link. Just may be a good thing to have in your back pocket.

:bighug::bighug::bighug::bighug:
 
Thank you for the prayers!
Thanks for the link, @JaxBenji . I know @Aleluia Grugru & Minnie has lots of feeding tube experience, too, and mentioned it on my condo yesterday. I wanted to ask more about it but it slipped my mind....so question for both of you...

Aleluia Grugru & Minnie said:
Ondansetron should be 2mgs at least. Minnie gets 4mgs x2 a day. If she got the Cerenia shot before coming home, that will last 48 hours so it should give you time to get a refill at the vet on Tuesday. Minnie is also on metoclopromide which helps her no regurgitate the food she eats back up.

The feeding tube may be needed if she continues not to eat. Minnie had it and it was a blessing. Ask what type they’d be inserting traqueal or stomach.
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I would be very open to getting one for Butters if it is the right thing to do for her. What type did Minne have? How about Jax?
I don't know if we are nearing that point yet. Maybe we are? The ER said if she isn't eating on her own in 12-24 hours to bring her back and they would feed her through an NG tube...I hope they'd let her come home with it. They didn't even wanna send fluids home for me to administer.
Thankfully Butters hasn't been vomiting any food back up. I gave her 2mg of Ondansetron today, but the vet only gave me 10 mg total.
 
Oh my.... what a terrible ordeal. I have had to resort to syringe feeding Milo on multiple occasions. Sometimes that was enough to get him to eat on his own. The extra fluid I mixed it with also hopefully prevented dehydration. Might that be something to attempt before another ER visit? You don’t want to give too much and have him vomit. Maybe small amounts frequently??? I think that they get into a cycle that the less they eat, the less they want to eat. Milo seemed to perk up after a few feeds then started to nibble on his own. Maybe more experienced members have an opinion on this???
Good luck. Finding a good vet is VERY difficult. I seem to have to “partner” with mine and make suggestions from the members here but he’s excellent about going with it. I hope things turn around soon...
 
Just to recap: she had ondansetron, zyrtec and bupre this morning.
She is fighting the syringe feeding.
She chewed tuna and a freeze dried chicken treat and spat them out.
She has five different plates of foods, all of which she has sniffed. None eaten. So no eating or drinking so far today.
So she hasn't eaten or drank since i was able to syringe feed her 10 grams of food and 10 ml of water last night between 9pm - 11pm.
Her tummy is hard.
She hasn't peed since she has been home (20 hours or so)
Last BM sunday evening.
Twitching has been going on since Friday, so before she was on any medications. It seems to be a little worse since she came home from the ER though.

I am boiling a chicken drumstick and will see if she will have the broth or eat that chicken. And will go buy baby food (without onion or garlic) and try that.

The ER sent me a copy of her entire record, including pictures of the xrays they took! Pretty cool. LOL. I am working on typing all of her lab work into my spreadsheet.
 
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There is a possibility of gallstones blocking the pancreatic duct. If so, only an ultrasound will reveal if he duct is blocked and if so, by what.

That would cause her tummy to feel hard. Also keep in mind she's in pain, she could be clinched up as well...

Either way, it's not a pleasant day for Butters...
 
Butters & Lyla said:
I would be very open to getting one for Butters if it is the right thing to do for her. What type did Minne have? How about Jax?
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Jax had an e-tube; looks like ER admitted him and transferred him to the internal medicine team - the internal med team did the e-tube. As for deciding on the feeding tube, I didn't research a thing and just went off the internist but it does sound like e-tubes are popular. His records say he was on Hills a/d (which makes sense since several people here recommended that). His tube was in for about 3 weeks but it looks like I only used it for feeding for about a week (rest of the time was his cocktail of meds).

The only thing I do know about the feeding tube decision is you don't want to wait too long as there needs to be anesthesia so the kitty needs to be stable enough for that. Maybe someone else will chime in here on the "right time" to decide.

Just as an NB, in Jax's case we were battling a severe stomach ulcer and suspected sepsis; he was also hypoklamic (low potassium)...I remember that part the most for some reason as we kept tweaking his potassium supplement. He ended up beating his infection with meropenum. I think I have this all right...I wish I was on FDMB two years ago though he wasn't diabetic yet :)

Sending clarity to you and the doctors and strength to Butters :bighug::bighug::bighug:
 
Just to clarify an e-tube = endogastric tube, ng-tube = feeding tube...just different terms that med folks use to describe a thin tube that is inserted down the nasal passageway into the stomach so that kitty can breath, and there can be a nutrient rich, liquid slurry delivered into their tummy - it's hydrating and has electrolytes and other important ingredients to help stave off further complications ...

Those darn med professionals don't want to make it easy for you to understand what they're saying 90% of the time...and tend to use a lot of acronyms and abbreviations - I wish they were more clear in a consistent manner with everyone.
 
Sue and Luci said:
Just to clarify an e-tube = endogastric tube, ng-tube = feeding tube...just different terms that med folks use to describe a thin tube that is inserted down the nasal passageway into the stomach so that kitty can breath, and there can be a nutrient rich, liquid slurry delivered into their tummy - it's hydrating and has electrolytes and other important ingredients to help stave off further complications ...

Those darn med professionals don't want to make it easy for you to understand what they're saying 90% of the time...and tend to use a lot of acronyms and abbreviations - I wish they were more clear in a consistent manner with everyone.
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I'm definitely not an expert with terms but Jax had an esophagostomy tube (through his esophagus...not nasal). Looks ilke the choices for cats are that one or the p-tube (pharyngostomy). Lisa's article that I linked earlier is a nice simple summary - link.
 
Animal health partners was on my list when deciding where to take Butters on Saturday. I ended up taking her here: https://ctvrc.ca/ mainly because it was closer and because the vet who ditched Butters as a patient had referred her to an IM specialist there, who was also recommended by a former vet tech friend-of-a-friend.
I guess I chose wrong...I didn't spend enough time reading to discover that animal health partners has a special relationship with OVC.
 
I’m sorry Butters is not doing well today :(.
If she continues to struggle with the syringe I would be inclined to take her back to the hospital—but maybe a different one? I know that is not what you want to do, however the IV fluids alone make such a major difference with a pancreatitis flare let alone the other additional intensive treatment options they are able to provide if needed. It is not uncommon for cats to spend 2-3 days hospitalized receiving IV fluids and other care. It’s not just about hydration but also about perfusing the pancreas and flushing digestive enzymes out of the body.

There was a time that I kept T home and after the fact, because hindsight is always 20/20, I realized that I should have left him because it would have expedited his recovery and reduced the amount of time it took to get him out of the ditch. Granted, it has to be a hospital that your trust implicitly to manage the flare appropriately.
 
Butters & Lyla said:
Animal health partners was on my list when deciding where to take Butters on Saturday. I ended up taking her here: https://ctvrc.ca/ mainly because it was closer and because the vet who ditched Butters as a patient had referred her to an IM specialist there, who was also recommended by a former vet tech friend-of-a-friend.
I guess I chose wrong...I didn't spend enough time reading to discover that animal health partners has a special relationship with OVC.
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I think you made a decision on solid information that you had and sometimes there is no way of knowing how it will turn out until you are in the situation.

I personally prefer U settings (for myself and my pets) or if you are not too far from an ER clinic that has a relationship with one, like the one in Toronto has, that’s a nice option.
 
Tomlin said:
I’m sorry Butters is not doing well today :(.
If she continues to struggle with the syringe I would be inclined to take her back to the hospital—but maybe a different one? I know that is not what you want to do, however the IV fluids alone make such a major difference with a pancreatitis flare let alone the other additional intensive treatment options they are able to provide if needed. It is not uncommon for cats to spend 2-3 days hospitalized receiving IV fluids and other care. It’s not just about hydration but also about perfusing the pancreas and flushing digestive enzymes out of the body.

There was a time that I kept T home and after the fact, because hindsight is always 20/20, I realized that I should have left him because it would have expedited his recovery and reduced the amount of time it took to get him out of the ditch. Granted, it has to be a hospital that your trust implicitly to manage the flare appropriately.
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Yeah, that's definitely on the table. I would take her to Animal Health Partners. The CTVRC was supportive of me taking her home to try to get her to eat and drink because she was so nervous at the hospital. I'm going to try syringing her again.
 
Yay!!!:bighug::bighug::bighug::bighug: Sounds like she was hungry and it went well?

Set up your Feline Masterchef YouTube Channel :p. Today’s segment will be “OMG My cat HAS to eat!”:nailbiting::woot:
 
Sending prayers to Butters and you :bighug::bighug:

Minnie had a traqueal it e-feeding tube. She wasn’t eating on her own and on the second day the ER transferred her to internal medicine where they inserted the tube. The IM didn’t want to send her home without it because of the diabetes. Apparently, the tube could also be placed at the stomach and that’s what she recommended since it can stay longer and had less risk of infections, but during the procedure she couldn’t get the placement to work right and went with the other one. I don’t have any experience with the nasal tube. I know it’s much thinner so you’d have to likely water down the food event more and blend it really well. I feel that if she’s still not eating today, I’d take her back as others suggested and maybe to the other hospital. Reading through the thread the folks at the ER she was at didn’t seem very compassionate or willing to work with you. It shouldn’t be an uphill battle to get the meds she needs prescribed.

You can go up to 4mgs or ondansetron twice a day. It can also be given every 8 hours so 3 times a day
 
Her BG is 265. The cherry on top of all the other things wrong with her right now.
I was so focused on trying to get her to eat something this morning that I didn't think whether I should give her insulin or not.
She hasn't been this high in five weeks. I will be giving her full dose tonight or sooner if I'm bringing her back to the ER, unless anyone thinks otherwise. I hope she will become tightly regulated again. Ugh.

She also just peed on my bed.
 
Glad she had some broth. Did someone mention hard belly? That concerns me for a few reasons. Maybe that ultrasound or xray should be considered. She is not going to eat if nauseous, I know they won't give you cerenia. NG tube is through the nose, that would be quite bothersome for Butters. E-tube would be better. Is there a different ER instead of the one you were at you can go to? Insulin-she needs some but I don't know about full dose or not. Hope you can get primary vet sooner rather than later.
 
thebigfuzz said:
Hi Lyla!
I’m in Vancouver, as you know, it I did a quick search for diabetes specialists (and internal medicine specialists),

https://ctvrc.ca/about/#our-team
https://animalhealthpartners.com/toronto-veterinarians/
https://www.google.ca/amp/s/www.annexvet.com/diabetes-mellitus-cats/amp/
https://www.google.ca/amp/s/www.annexvet.com/diabetes-mellitus-cats/amp/
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Thank you! :bighug::bighug: The first one is the ER she went to on Saturday. The second one is the next ER she goes to if she needs to go back.
I'll put annex vet on my list for possible primary. Thanks Tanya!
 
Olive & Paula said:
Glad she had some broth. Did someone mention hard belly? That concerns me for a few reasons. Maybe that ultrasound or xray should be considered. She is not going to eat if nauseous, I know they won't give you cerenia. NG tube is through the nose, that would be quite bothersome for Butters. E-tube would be better. Is there a different ER instead of the one you were at you can go to? Insulin-she needs some but I don't know about full dose or not. Hope you can get primary vet sooner rather than later.
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Yes her belly has been hard. I could go to a different ER.
And she just peed on my couch...after peeing on my bed a short while ago. Her litter box is right here. She is jumping up and down the bed and couch...moving around relatively well. I've put her in her litter box a couple of times but she just jumps out. She is peeing right where she lays. And then the wet spot is there when she moves.
 
Butters & Lyla said:
Thank you! :bighug::bighug: The first one is the ER she went to on Saturday. The second one is the next ER she goes to if she needs to go back.
I'll put annex vet on my list for possible primary. Thanks Tanya!
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You are welcome :bighug: The one in Scarborough looks fairly impressive too....at least from a technology/clinic standpoint.
 
Butters & Lyla said:
Yes her belly has been hard. I could go to a different ER.
And she just peed on my couch...after peeing on my bed a short while ago. Her litter box is right here. She is jumping up and down the bed and couch...moving around relatively well. I've put her in her litter box a couple of times but she just jumps out. She is peeing right where she lays. And then the wet spot is there when she moves.
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I am so sorry :( to hear about the peeing. I haven’t had T urinate on himself or out of his box but if they are in enough pain they will hesitate to move—even to use the litter box. I’ve had to do what you’ve done & put the box where he is. Note that even if there is enough pain to make them hesitate to move, they can look pretty normal when they do decide to move. When he finally felt better, he would not use the box in the room with him and would venture off to his normal spot across the house.

I do give insulin to T when he is in a flare & I have to adjust the dose based on how much his BG is impacted by the underlying inflammation. At the same time, I have to make sure not to be overly aggressive with dosing in case 1) he suddenly won’t eat or eats less and 2) he needs to be taken to the vet- Ts BG plummets when he goes to the vet vs increasing and 3) in case the inflammation starts to decrease and the BG comes back down. Sometimes it decreases it’s slowly and sometimes it’s more sudden so I don’t want to have too much insulin on board and risk dropping to a dangerous place
 
She ate a tablespoon of a/d, with a bit of pumpkin and water. But mostly a/d.:)

I'm not sure what to do with dosing insulin for tonight. I figured as long as she was eating and because her depot is probably pretty empty by now, that I could do a full dose. But I didn't consider whether the vet would raise or lower her BG, or if the 265 is partly because of the flare up. WHen she was in the ER and they were doing spot checks, she was relatively low.

If anyone happens to come by who can offer dosing advice, do you think I'm ok to shoot a full dose tonight? Assuming she is still eating.

No vomiting since Saturday morning. Hasn't had insulin since Saturday morning.
 
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I think with what u said I personally think a full dose is fine just make sure to monitor since she’s eating and depot is empty and no more puking whooo hooo
Hopefully other will way in
 
How many hours until you have to decide on dose? Amy is right, this is a tricky situation. Pain, and pancreatitis is painful, can raise the BG numbers. Addressing pain can lower them. Inflammation can do the same. You have probably lost the depot now, so she needs some insulin. You also have to decide if she's going back to the vet today/tonight. And if she's one of those cats whose number rise or fall at the vets. Neko like to drop at the vets.
 
Just here to celebrate eating!
giphy.gif
 
Wendy&Neko said:
How many hours until you have to decide on dose? Amy is right, this is a tricky situation. Pain, and pancreatitis is painful, can raise the BG numbers. Addressing pain can lower them. Inflammation can do the same. You have probably lost the depot now, so she needs some insulin. You also have to decide if she's going back to the vet today/tonight. And if she's one of those cats whose number rise or fall at the vets. Neko like to drop at the vets.
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Agree. @Tomlin you gave me so many things to consider.
Butters has gone through a vet visit, an ER stay and a shave this week...and her numbers have remained the same: neither up nor down. Except toward the end of her ER stay, they started to rise but probably that was from the depot draining. I have no other vet visits to go off of. The last time she got a shave, her numbers dropped.

I could realistically shoot anytime up to 9pm and work my way back if needed, but 630pm would be her normal time.
She is getting 0.08mg bupe every 8 hours. I can tell Butters is still in pain...still meatloaf with a pinched face. :(
She has yet to eat on her own. I am going to do another two syringe feeds shortly.
Regardless, I do have to take her to a vet tomorrow. THe ER refused to send me home with fluids for her, so poor girl must be dehydrated. I don't think I cannot give her enough liquid orally.
I don't know. Maybe another hospital could address her pain and nausea better? But I'm getting food into her. Maybe she isn't in as much pain as I think?
 
Olive & Paula said:
Glad she had some broth. Did someone mention hard belly? That concerns me for a few reasons. Maybe that ultrasound or xray should be considered. She is not going to eat if nauseous, I know they won't give you cerenia. NG tube is through the nose, that would be quite bothersome for Butters. E-tube would be better. Is there a different ER instead of the one you were at you can go to? Insulin-she needs some but I don't know about full dose or not. Hope you can get primary vet sooner rather than later.
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I don’t have experience with the NG tube but I was thinking it would be bothersome, especially in trying to get the food through because it’s so much thinner...
 
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