Syringe feeding, feeling hopeless

Status
Not open for further replies.
Critter Mom said:
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?


Mogs
.
Click to expand...

I know right? No more tests after those on Wednesday, just glucose curves. But I think those values from Wednesday are evidence enough that he should not have gone home.

Critter Mom said:
Food is a cornerstone of DKA treatment. Adequate calories and insulin are key to restoration of normal metabolic function.


Mogs
.
Click to expand...

The tech said she syringe fed him this morning and will again this evening. I brought up the NG tube, but she confirmed that he was easy to syringe feed and she would continue to do so BID. The vet wasn't in the clinic today for some reason so I couldn't speak directly with him.
 
Hey all, Frankie is doing well. Still mostly refusing food and having to be syringe-fed. He did lick up a bowl yesterday but that was it. Vet says she doesn't believe he's a candidate for anesthesia for tube-feeding... I think she might have misunderstood me because I didn't think NG tube placement required anesthesia. As long as he's eating, I suppose. They also got him on PZI insulin yesterday and his BG got down to 116, which is exciting news. Vet says he is looking brighter and brighter each day. I requested a urine culture to make sure he doesn't have a UTI. I ordered some Prozinc for when he gets home.

Since he's been in the unit since Saturday with multiple tests and services, I'm beginning to slightly worry about the cost of his stay. I just hope it's at least less than $5k. I have the funds to cover it if it's over but it is still a bit distressing to think about. I might ask for a rough quote next time I get a call. Still, I'd pay anything to have him come home the right way.
 
jt and trouble (GA) said:
if they wont...insist on it. You need to know this information and they should be able to provide it.
Click to expand...

Agree... I'm actually surprised they didn't give you an estimate before admitting him. In my experience, they like to tell you before treating so people don't give them an "I'm not paying that!!!!!" at the end of treatment.
 
Hi Alayna,

Great to hear that Frankie's recovery continues apace.

alayna said:
He did lick up a bowl yesterday but that was it.
Click to expand...
That sounds like nausea-related behaviour. Do you know what they're doing to manage nausea and stimulate Frankie's appetite? (The first needs to be dealt with before the appy stimulants will work.)

Do you know whether or not Frankie might be constipated? That can negatively impact appetite as well. If he is then a couple of days' treatment with a prokinetic like metoclopramide can help 'get things moving' again once any stuck stool or other GI obstructions are dealt with/ruled out.

(((Frankie)))


Mogs
.
 
Sorry Alyana but it sounds like you’re really going to have to push back and have your questions answered. You need to know for sure everything that’s happening so make sure they answer all your questions and don’t get off the phone until they do. What are they actually doing? I’m confused if they didn’t add the nasal feeding tube to make sure he’s eating well, are they only giving him fluids? What anti nausea meds are they giving him and what else are they doing?

It’s absurd that you don’t have a quote for this treatment. I’d call them back today and demand it as JT put it.
 
Meant to add earlier that metoclopramide alone is not enough to treat feline nausea because it is considered that cats have very few of the receptors it targets to control nausea in other species (see link below). Additional anti-nausea support is needed (Cerenia and/or ondansetron).

[ETA]

IDEXX Pancreatitis Treatment Guidelines (See section on nausea control.)

Another thing to consider: if Frankie's being given an antibiotic by mouth then that may upset the GI tract. Anti-nausea meds can also help counter this issue. (My civvie, Lúnasa, is currently on a long course of amoxycillin/clavulanic acid and I need to give her ondansetron along with it. Even with the anti-nausea support her appetite is quite hit 'n' miss and she needs prompting and encouragement to eat a lot of the time. Without the anti-nausea support I would be struggling to get any food down her at all at the moment.)

Low potassium levels are another thing that may possibly contribute to poor appetite. Have the vets given you any info on how things are going with Frankie's electrolyte balance?


Mogs
.
 
Last edited:
Critter Mom said:
Meant to add earlier that metoclopramide alone is not enough to treat feline nausea because it is considered that cats have very few of the receptors it targets to control nausea in other species (see link below). Additional anti-nausea support is needed (Cerenia and/or ondansetron).

Another thing to consider: if Frankie's being given an antibiotic by mouth then that may upset the GI tract. Anti-nausea meds can also help counter this issue. (My civvie, Lúnasa, is currently on a long course of amoxycillin/clavulanic acid and I need to give her ondansetron along with it. Even with the anti-nausea support her appetite is quite hit 'n' miss and she needs prompting and encouragement to eat a lot of the time. Without the anti-nausea support I would be struggling to get any food down her at all at the moment.)

Low potassium levels are another thing that may possibly contribute to poor appetite. Have the vets given you any info on how things are going with Frankie's electrolyte balance?


Mogs
.
Click to expand...
Absolutely. Metoclopramide, which Minnie is on btw, needs to be used in conjunction with an anti nausea like ondansetron or Cerenia. It only works to help stop the reflux to regurgitate. It doesn’t address the nausea
 
Okay folks, sorry for getting back so late but I think this will be one of my last updates --

Frankie is doing great. He is finally eating on his own, the vet said he cleaned his plate both last night AND this morning. His BG was very high, around the 500s, so still dosing 2 units of PZI. She took him off of fluids today and she says he is ready to come home to me this afternoon. She's sending me home with some Cerenia (oral) and I told her I already had transdermal appetite stimulant (Mirataz).

She asked me about my diet plans, and I told her I wanted to go back to completely wet and carb-free, which she agreed with, but she mentioned it may be best for Frankie for now if I just keep him on dry food for a while to try to get his weight and strength back up before I start the transition back to wet. Her reasoning is that he was eating so well with dry food on his own (They were giving him Royal Canin glycobalance) and she wants to make sure he's eating just as well throughout his recovery. I'm inclined to agree because Frankie oftentimes eats WAY more if I give him dry food vs wet. (He's a crunch addict.) I may consider looking into very low carb dry foods as an option somewhere down the line if the transition back to wet is too troublesome.

I asked about potential infections and she confirmed that he had been given some antibiotics including one that should last him 14 days (she told me the exact drug but I can't remember it now.)

My instructions are 2 units Prozinc twice a day. I ordered Prozinc from Chewy and it might not come in for a day or so so I'll have to dose him with Vetsulin with close monitoring until then. I'll mention that to my vet when I go and see what she thinks.
 
tiffmaxee said:
One low carb dry foods are Dr. Elsey’s available from Chewy and Young Again which needs to be ordered from them directly. I’m glad Frankie is coming home and hope you stick around. :bighug:
Click to expand...

Thank you so much!! I definitely plan on sticking around because I'm planning on being more stringent with his regimen so I'm sure I'll have a ton of questions, lol :p
 
Hi Alayna,

Very pleased to hear that Frankie's now taking food on board under his own steam. :)

I'm with your vet re keeping Frankie's eating as stable as possible during recovery. The additional carbs during the convalescent period will also support the administration of a little more insulin than a low carb food would, and that can also be helpful for recovery.


Mogs
.
 
alayna said:
Okay folks, sorry for getting back so late but I think this will be one of my last updates --

Frankie is doing great. He is finally eating on his own, the vet said he cleaned his plate both last night AND this morning. His BG was very high, around the 500s, so still dosing 2 units of PZI. She took him off of fluids today and she says he is ready to come home to me this afternoon. She's sending me home with some Cerenia (oral) and I told her I already had transdermal appetite stimulant (Mirataz).

She asked me about my diet plans, and I told her I wanted to go back to completely wet and carb-free, which she agreed with, but she mentioned it may be best for Frankie for now if I just keep him on dry food for a while to try to get his weight and strength back up before I start the transition back to wet. Her reasoning is that he was eating so well with dry food on his own (They were giving him Royal Canin glycobalance) and she wants to make sure he's eating just as well throughout his recovery. I'm inclined to agree because Frankie oftentimes eats WAY more if I give him dry food vs wet. (He's a crunch addict.) I may consider looking into very low carb dry foods as an option somewhere down the line if the transition back to wet is too troublesome.

I asked about potential infections and she confirmed that he had been given some antibiotics including one that should last him 14 days (she told me the exact drug but I can't remember it now.)

My instructions are 2 units Prozinc twice a day. I ordered Prozinc from Chewy and it might not come in for a day or so so I'll have to dose him with Vetsulin with close monitoring until then. I'll mention that to my vet when I go and see what she thinks.
Click to expand...
Glad to hear Frankie is doing so much better. Hope to see further updates over the weeks as to how he progresses
 
I want to give a HUGE thank you to everyone who helped me out in this thread, seriously, I don't know what I would have done if I hadn't made this post!!! I might not have brought him to the vet on time... and you guys helped me so much with communicating with my vet and making sure everything got done right. MANY THANKS!!! :bighug::bighug::bighug:

And for anyone wondering, his total for the 4 night stay was $985. Not as bad as I was expecting, they definitely helped out and didn't charge for a lot of items.
 
Status
Not open for further replies.
Back
Top