Syringe feeding, feeling hopeless

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alayna

alayna

Member Since 2019
Hey all. I'm in a really tough spot with my cat and I'm looking for some words of wisdom. Frankie has just started back up on insulin after a year of remission, but this time it's looking a lot worse. When he was first diagnosed, he was somewhere in the 500s (mg/dl) but the only symptoms were the drinking, peeing, and a little touch of lethargy. But for some reason this time around, he's become like a vegetable... only laying in one or two spots, never walking around -- and when he does, he trips and wobbles. He's been just laying down for several days so I'm assuming he's very weak at this point. He's lost a lot of weight, around 0.6 lbs over the past couple months, and the ridge of his spine is visible.

I've had to syringe feed him previously, when the vet diagnosed him with IBD and figured he was refusing to eat because he had been so backed up it was making him sick. His symptoms then were excessive gulping, retching, and occasionally vomiting mucus. I had to put him on a dry GI food for a while to help him with that situation, and it did, he got a lot better...normal BMs and eating normally... however, I think that dry food triggered a relapse.

I just don't understand why he's so frail and refuses to eat (or even drink) now. The vet said he probably was feeling too bad because of his BG to eat, but that doesn't really make sense to me because in clinic his highest was 370. They said the glucose in his urine was. "1000". Why would that make him completely refuse to eat, when only 2 years ago his BG was in the 500s and that didn't affect his appetite at all? He got full bloodwork and urinalysis and everything else looked okay. He is not displaying the same symptoms of bowel obstruction as before, only the refusal to eat.

It's just tough syringe feeding him twice a day, and then shooting afterwards... I was honestly happy to put him back on insulin because of how much energy it gave him last time around (he acted like a young cat again), but this time it seems to not really effect his energy at all. I'm waiting for an Alpha Trak to come in the mail, but in the meantime I've been taking crude BG tests using an old ReliOn meter and he's not bottoming out. (I say crude because I'm not yet able to produce enough blood to really get an accurate result on a human meter.) Some readings I got were 166, 230. The 166 was 2 hours after shooting, and the 230 was 5 hours after.

Has anyone here gone through something similar, having to force feed while on insulin? My heart hurts to think that Frankie might reaching the end of his life.

If I'm still having to force feed by Monday I'm calling the vet, but I don't know what that could even accomplish at this point...

Some info:
  • Male, neutered
  • 12 Years old (born 2008)
  • Domestic shorthair / siamese
  • 12.4 lbs and underweight for his size
  • Vetsulin, 1 unit BID (I want to switch him to Prozinc if he's not looking better by the end of this weekend because that's what I've used in the past)
  • Fancy feast Beef Pate Senior 7+ 3 oz can BID
  • I gave him 1/8 tsp MiraLax this morning
  • On insulin Jan 2019-June 2019, Remission until now (October 2020)
 
I’m sorry Frankie isn’t feeling well. I suspect it’s not just diabetes with those symptoms or else DKA.. Was a full blood panel run and a urinalysis? It also could be pancreatitis. I agree with Kel.
 
Red & Rover (GA) said:
What comes to mind is DKA – diabetic ketone acidosis – which is life threatening and requires vet treatment.
DKA = not enough insulin + not enough food + something else going on (infection or inflammation).

Can you get him to a vet today? Like, now?

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I had suspected DKA as well, but he was at the vet all day yesterday, in the exact same condition, and they did not find ketones.
 
tiffmaxee said:
I’m sorry Frankie isn’t feeling well. I suspect it’s not just diabetes with those symptoms or else DKA.. Was a full blood panel run and a urinalysis? It also could be pancreatitis. I agree with Kel.
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Yes it was full bloodwork and urinalysis, he said everything else looked normal. I was thinking it was DKA all day Thursday but ketones were not present.
 
tiffmaxee said:
Did they test for pancreatitis? Do you have or can you get a copy of all tests run?
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Frustratingly, my vet never has Frankie's labs available for me to look at. I even asked him at what time the insulin peaked during his curve on Friday and he could not give me a straight answer. But I'm not sure what a pancreatitis test entails--would that come out in a full bloodwork and urinalysis panel?
 
alayna said:
Yes it was full bloodwork and urinalysis, he said everything else looked normal. I was thinking it was DKA all day Thursday but ketones were not present.
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The test for pancreatitis is not part of the panel. Max had chronic pancreatitis for a few years before becoming diabetic. It’s very common with diabetic cats for unknown reasons. He was eating less and less and then just stopped eating. Common symptoms are inappetence, pain, just not acting right. They are usually very nauseous but don’t always vomit. That’s why I missed that nausea was part of his problem.
 
The test you need is the SpecfPL. It’s a blood test sent to the lab. You have paid for the tests and he has to give you a copy. I would be looking for another vet but for now insist the labs be emailed to you. I can’t tell you how many times I was told all was normal but when I looked at the labs saw warning signs. A friend informed me my cat was becoming anemic. The vet said normal labs.
 
tiffmaxee said:
The test for pancreatitis is not part of the panel. Max had chronic pancreatitis for a few years before becoming diabetic. It’s very common with diabetic cats for unknown reasons. He was eating less and less and then just stopped eating. Common symptoms are inappetence, pain, just not acting right. They are usually very nauseous but don’t always vomit. That’s why I missed that nausea was part of his problem.
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Okay, I found a vet that's open now and I'm gonna take him there to be tested for DKA and pancreatitis.
 
The pancreatitis tests - Snap fPL and Spec fPL - need to be ordered in addtion to the standard blood panels.

Do you have urine test strips at home? If not I'd suggest grabbing some and monitoring for ketones at home. They can build up very quickly. It's a good general safety precaution, better to keep on top of things so that if they were to appear you would be in a position to act quickly.


Mogs
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alayna said:
Okay, I found a vet that's open now and I'm gonna take him there to be tested for DKA and pancreatitis.
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Very glad you've found a vet who can help. Ask if they can run a Snap fPL test as well as the Spec fPL, as the first test can give an on-the-spot, yes/no/unclear result (works a bit like a pregnancy test), which means the vet might get a faster indication of treatments needed while waiting for the results from the external lab's assessment of the Spec fPL test.

I'd suggest asking about potassium levels too - if they're off that can affect appetite. Not sure when your kitty last pooped but a check for constipation is a good idea too.

If it is pancreatitis, your little one will need meds for anti-nausea, appetite stimulation and pain relief. This is a very helpful guide to treatment and what to ask the vet about if the Snap test is positive:

IDEXX Pancreatitis Treatment Guidelines

Be sure to let us know how you get on.


Mogs
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Just got back from the vet. It was DKA. Doc showed me his labs, and as a pharmacy student, I was horrified. Frankie is now hospitalized, probably throughout the weekend. He also had a UTI and protein in his urine (BOTH of which my previous vet said he did not have -- yes I am changing vets.)

I am so overwhelmed. I hope he can pull through. Doc said "he's been sick for a long time."

Thank you again for all of your advice. If I hadn't made this post, I probably would have waited until Monday.
 
(((Alayna and Frankie)))

Thank goodness you found that vet today! Frankie's in the right place to get the help he needs now. Fingers and paws crossed that he'll soon be feeling much, much better.

When he's ready to come home, be sure that the vet gives you some anti-nausea and appetite stimulant meds for home use so that if Frankie needs a bit of help with eating during his recovery you'll be able to respond straight away. (Difficulty eating during convalescence can lead to relapses and having the meds immediately to hand is a great preventative measure.)

Sending prayers for a speedy recovery for Frankie. Again, thank the gods that you found a good vet.

:bighug:


Mogs
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Vet confirmed DKA. Ketones present,
Critter Mom said:
(((Alanya and Frankie)))

Thank goodness you found that vet today! Frankie's in the right place to get the help he needs now. Fingers and paws crossed that he'll soon be feeling much, much better.

When he's ready to come home, be sure that the vet gives you some anti-nausea and appetite stimulant meds for home use so that if Frankie needs a bit of help with eating during his recovery you'll be able to respond straight away. (Difficulty eating during convalescence can lead to relapses and having the meds immediately to hand is a great preventative measure.)

Sending prayers for a speedy recovery for Frankie. Again, thank the gods that you found a good vet.

:bighug:


Mogs
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thank you!! I actually have some mirataz from his last visit. I'll make sure to ask for anti-nausea as well.
 
alayna said:
Just got back from the vet. It was DKA. Doc showed me his labs, and as a pharmacy student, I was horrified. Frankie is now hospitalized, probably throughout the weekend. He also had a UTI and protein in his urine (BOTH of which my previous vet said he did not have -- yes I am changing vets.)

I am so overwhelmed. I hope he can pull through. Doc said "he's been sick for a long time."

Thank you again for all of your advice. If I hadn't made this post, I probably would have waited until Monday.
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Thank God you did post today I'm praying for your Frankie , and glad you said you are changing vets. Poor baby . please keep us updated :bighug::bighug:
 
Hi Alayna,

Thinking about yourself and Frankie. You've had such a rough time of things recently. I know it's hard when you're worrying about your fur baby, but I hope you can get a good night's sleep for yourself while the vets are watching over Frankie for you. It will be a help to both of you to grab the chance to recharge the battery a little. :)

Sending more prayers for your little fella.

(((Frankie)))

:bighug:


Mogs
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Critter Mom said:
Hi Alayna,

Thinking about yourself and Frankie. You've had such a rough time of things recently. I know it's hard when you're worrying about your fur baby, but I hope you can get a good night's sleep for yourself while the vets are watching over Frankie for you. It will be a help to both of you to grab the chance to recharge the battery a little. :)

Sending more prayers for your little fella.

(((Frankie)))

:bighug:


Mogs
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Thank you so much for your kind words! It has been difficult, I feel like I've shed enough tears to last a lifetime -- but I know I'll be okay. You're right, I'll definitely be able to sleep better while he's at the hospital. <3
 
I have an update for y'all -- I got a voicemail from the tech this morning (they are closed today) and she informed me that this morning Frankie was sitting upright, perked up, and watching the techs do their work around the ICU! This is incredibly huge news for me and I couldn't be happier. They're keeping him on fluids for a while because he's still dehydrated, but definitely feeling loads better. His BG was 166, which she said is normal given he's so sick that his levels go all over the place, but he was given insulin yesterday morning and last night. She will check again this afternoon and give him insulin again if he's higher.

:D

Also I'm going to call the previous vet tomorrow when they're open and request all of Frankie's labs up to date be emailed to me.
 
Frustrating call this morning from a tech. Asked me if I would be willing to come by the clinic to hand feed him because he was still not accepting oral food. I asked if he had received nutrition over the weekend and she said no. I told him I had been syringe feeding him, not hand feeding. She asked me what she should syringe feed him. I told her any wet food mixed with water so she can get up into the syringe is fine.

I am once again back in my little hole of hopelessness!! Is IV nutrition for feline not a standard practice? Or at least syringe feeding?? My goodness, Frankie has not eaten all Sunday... surely won't make him get better any faster. Not to mention now I'm worried this tech might make my guy aspirate. Geez. Also, he apparently was given Cerenia this morning.

BG was 230 this morning.
 
Aleluia Grugru & Minnie said:
This doesn’t sound right to me. Yes, they should have been feeding him via a nasal feeding tube. Can you call and ask to speak to the vet who is working this shift?

@Critter Mom and @tiffmaxee thoughts?
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I'm gonna make sure they know to syringe feed over the weekends, and I'd prefer it that way over the week. He generally accepts the syringe very well and the idea of Frankie having an NG tube upsets me... but I know I'm probably being too sensitive :(
 
I would be upset too as not eating for a cat can lead to hepatic lipidosis. How long were you needing to syringe feed him? When an ER suggested a feeding tube as a possibility for one of mine I felt like you. It was my first experience with a cat on so many meds and so sick. I might feel differently today. How is he otherwise? Some cats won’t eat at the vet. Do you know what medications they are giving him? Is he getting an appetite stimulant?
 
tiffmaxee said:
I would be upset too as not eating for a cat can lead to hepatic lipidosis. How long were you needing to syringe feed him? When an ER suggested a feeding tube as a possibility for one of mine I felt like you. It was my first experience with a cat on so many meds and so sick. I might feel differently today. How is he otherwise? Some cats won’t eat at the vet. Do you know what medications they are giving him? Is he getting an appetite stimulant?
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I syringe fed him twice on Friday and once on Saturday before bringing him to the new vet. The old vet had been syringe feeding him daily while he was in their care. I tried giving him Mirataz but that of course did not help as he was too sick to eat anyway, so I just resorted to the syringe. If they tried an appetite stimulant in clinic I'm sure it didn't work for them either. And apparently they also gave him Cerenia.
 
It’s true it did! The feeding tube was a god send. I could feed her and give her all her meds and for 2 weeks until we had a treatment plan in place, I didn’t have to worry about her eating. She had a traqueal tube inserted and I’m not saying that’s the one you need as it requires anesthesia and surgery but since she was going under for the endoscopy already, it made sense. However, a nasal feeding tube is something they can do while your cat is awake and it’s how an ER will feed a cat who is not eating. It’s standard procedure so I’d really press them on why they didn’t do that. Minnie wasn’t eating when I brought her to the ER and they did that right away. Then they switched her to the traqueal tube 2 days later.
 
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Frankie's urine ketones were through the roof on Wednesday 21 October!

Alayna, did that vet run any subsequent blood and urine tests before discharging him on Friday?


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