HELP ASAP!! Not Eating- Drinking Lots of water- high ketone test

Leigh B

Leigh B

Member
My Murphy threw up Friday morning. His BG was at 64, so I did not give him insulin. He did eat, and I tested him 2 hours later. He was at 143. 5 hours after that, he was at 503, so I gave him 1 unit.
I had to go out of town, so my husband fed him and gave him 2 units at dinner.
Saturday, he had breakfast and had his 2 units, as usual. My husband called around 6:45 pm and said Murphy had thrown up all over our bedroom and was not eating anything. He has been drinking lots of water.
I told him to avoid the insulin shot, since Murphy was not eating and I rushed home this morning.
I have tried to get Murphy to eat ANYTHING, and he is not interested. He is parked in front of the water bowl and is very lethargic.
I was able to catch some urine and do a ketone test. The strip showed that he has a large amount of ketones (80) in his urine (I test every month or so, and it is usually "none" to "Very little")
My usual vet is closed today. I am going to reach out to his last vet clinic, they open in 30 minutes.

Any advice? I have not updated his chart, but his numbers have been steady. He DID have a teeth cleaning and extraction over a week ago. All of his bloodwork, other than the diabetes, was normal.

Oh, and his BG was 326 at 12:30 and 388 at 1:05 today- a little while ago.
 
I think this is an emergency situation that requires you to get him to a vet immediately!
Signs of Diabetic Ketoacidosis (DKA)
  • Drinking excessive amounts of water OR no water
  • Excessive urination
  • Diminished activity
  • Not eating for over 12 hours
  • Vomiting
  • Lethargy and depression
  • Weakness
  • Breathing very fast
  • Dehydration
  • Ketone odor on breath (smells like nail-polish remover or fruit)
 
Hi Leigh,

If you haven't already managed to get Murphy in to a regular vet, please take him to an ER vet straight away.

Even if he's not already in DKA, high ketones need to be treated aggressively in a hospital setting. This is very much an emergency situation: DKA is life threatening.

Sending prayers for Murphy. When you can manage it, please let us know how things are going.

(((Murphy)))


Mogs
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Leigh B said:
Any advice? I have not updated his chart, but his numbers have been steady. He DID have a teeth cleaning and extraction over a week ago. All of his bloodwork, other than the diabetes, was normal.
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I hope you were able to get him to the alternate vet. Be sure to tell them about the dental, and see if they can do a mouth exam, hopefully including a set of dental x-rays if one wasn't done post-procedure. Sometimes there are post-extraction infections, sometimes also tiny little fragments of bone are left behind, causing problems.

Sending tons of healing vines for poor Murphy-- I hope he's feeling better very soon!
 
I have taken him to the vet. He is getting IV fluids now. They want to transport him to an emergency room for overnight observation (they do not have overnight staff at his clinic), but I'm afraid of the stressful environment & transportation. I may leave him on fluids for several hours, bring him home for the night and take him back in the morning. I'm afraid transporting from clinic to clinic will keep his stress level elevated.
His blood work did show high levels of ketones, but the rest of his blood work looked okay.
The vet is being wonderful and trying to help me weigh the need for observation versus the stress of all of the transportation and being in a hospital environment.
Thoughts on that?
I have about an hour to decide.
I'm leaning towards bringing him home so he will be comfortable.

As always, thank you all for the fast response and information.
I was sure to let them know about the dental. He was due for a follow-up at his regular vet to double check to make sure there was nothing left behind.
 
Hi Leigh,

I'm so glad you got Murphy to a vet. Thank you for posting an update on how things are going (we worry!).

I can completely understand your desire for treatment to be as minimally stressful as possible but even if Murphy's ketone levels were to drop after the IV fluids at the general practice vets, there's the risk that they could potentially build up again within a matter of hours.

I agree with Nan: I think the best thing would be to move him to the ER facility where they will be able to monitor him closely overnight. He might need aggressive insulin therapy to drive down the ketones and they would be best placed to provide intensive treatment and IV sugars as needed - and quickly. Also they need to get a handle on the nausea and inappetence. As Nan says above, when ketones are high things can turn on a sixpence.

(((Murphy and Leigh)))


Mogs
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Nan & Amber (GA) said:
I would go with the ER vet. Cats with high ketones can go downhill very very quickly.

Some questions: have they given him any insulin? have they gotten him to eat at all?
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They gave him some anti-nausea medicine and have not given him any insulin. Just IV fluids.
The vet said she feels okay with me bringing him home as long as I monitor him every 2 hours. Then, if things start to look stressful, I can take him to the ER clinic.
 
Will continue to pray for Murphy. Fingers and paws crossed that the ER vets will have him feeling much better very soon.

Try to do the best you can to get a someway decent night's sleep, Leigh. I know it's not easy but it's the best thing you can do for Murphy tonight. It will stand to you while you're caring for him during his convalescence.

(((Murphy and Leigh)))

:bighug:


Mogs
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Murphy did okay overnight at the emergency clinic. However, he is still not eating. They have given him an anti-nausea drug and are going to give him an appetite enhancer.
If he is still not eating, they are wanting to do an esophogastamy placement to get some calories in him. They said they can treat him for a while at the clinic and that is something that I can also administer at home.
This is certainly not news I was hoping for. Have any of you had experience with this?
I don't want to put this little fella through too much. I trust the vet but all seems so extreme, possibly because it's not what I am expecting or hoping for.
He was feeling great just three days ago.
 
I tagged Ale because I don't have personal experience with feeding tubes, but I can tell you what I've observed from reading posts around here. Positive reviews all around, basically. Having a cat who isn't eating and probably also needs regular medications to get over something is incredibly stressful. You know that if they would just eat they would start to feel better, but they don't know that and they can be very very stubborn. Having a feeding tube in place gives you the security of knowing that, whatever happens, they'll get enough food and their meds. You don't have to stay up all night trying to coax them, stressing out the whole time.

Frankly, if the vet is offering a tube, I'd probably take it as long as it seemed like eating was Murphy's main obstacle to wellness. I completely understand not wanting to put him through too much, but again, this is usually something that seems more drastic and extreme than it usually turns out to be. I wouldn't do it as part of a large suite of last-ditch efforts for the reason you state, but if he's got a good chance of recovery with just this, I think it's an excellent option, and I'm glad the vet offered it so relatively early here.

No matter what, though, it is 100% your decision. You're the one that is there and able to talk to the vet and get the really detailed view of the situation with Murphy that we don't have. And you also know your own situation and what is and isn't a reasonable course of action for you. We're here no matter what you decide.

:bighug: :bighug: :bighug: :bighug:
 
Thank you all so much.
I'm praying very hard that I will know the right path.
I'm torn because I don't want to put him through any more stress, especially another sedation. (Again, he had a dental procedure not even two weeks ago. His blood panel was fine, besides his glucose at that point in time.) I can't help but worry that the dental procedure has somehow caused this? It is the only thing that has happened with him in the last year.
I'm also wondering if he's not eating is a result of his body just being worn out.
On the other hand, I feel like if I can get him over this hump, he may be okay.
Praying that his appetite stimulant will work. If it doesn't, I may try to bring him home before going to the extreme of the feeding tube. The stress of being out of vet clinic for 2 days has got to be taking its toll. He is a cat who is more prone to stress then other cats I have had.:(
Also, if this really is getting to the end of the road, I don't want to use a feeding tube to extend the inevitable. Poor fella
 
Nan & Amber (GA) said:
Feeding tubes can be literal lifesavers, they sound a lot scarier than they are.

Tagging @Aleluia Grugru & Minnie who had one for Minnie, I know there are others around here with recent experience with them, she will know.

How is he doing other than not eating? What is his ketone level?
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She did not check his ketones this morning. She said her main concern is getting him to eat. She feels certain they are probably still pretty high.
I wonder if I could get him home and comfortable, I could get him to eat and then give him some insulin.
He has only had one unit of insulin since Saturday morning.
I thought that would help with ketones? I'm confused!
I wish I knew the magic answer to keep him comfortable and happy.:arghh:
 
They should be checking ketones and BG and administering short-acting insulin, yes. That is worrying to hear that they are not doing those things.

Another alternative is assist (syringe) feeding. It's hard to do for any length of time, but sometimes you just have to get them jump-started. You can do that at home, obviously, but are they at least trying to do that while he's at the vet, too? He needs to get some food into him!
 
The feeding tube is not as extreme as it sounds and it did save Minnie’s life I’m sure. She did very well on it. She jumped and played and it didn’t limit her quality of life at all. I swear I wish it could have stayed on forever because to be able to feed them and give them all the meds so easily is a God sent. If the vet is suggesting it and recommending it, I’d definitely let them do it. Minnie has a traqueal tube and it was very easy to use and clean. It started on for 2 weeks. I can give you tons of tips of how to handle it if you do it.
 
Aleluia Grugru & Minnie said:
The feeding tube is not as extreme as it sounds and it did save Minnie’s life I’m sure. She did very well on it. She jumped and played and it didn’t limit her quality of life at all. I swear I wish it could have stayed on forever because to be able to feed them and give them all the meds so easily is a God sent. If the vet is suggesting it and recommending it, I’d definitely let them do it. Minnie has a traqueal tube and it was very easy to use and clean. It started on for 2 weeks. I can give you tons of tips of how to handle it if you do it.
Click to expand...

THANK YOU!!!
He is not responding to the appetite stimulant. She is going to try another food.
I talked with my husband, and we both agree that Murphy has been in a good place lately. Again, he had blood panels done on 10/28, and everything looked ok (besides the expected elevated bg). Just Thursday, he was playing around the house with the energy of a kitten.
That said, I am hoping this is a "hump" we can move past.

Did Minnie eventually go back to eating normally? And, only 2 weeks with the tube?
Is Minnie back in a good place? One of my struggles is whether or not I should "put him through this" if he is just on a decline to the inevitable.

Thanks for the insight! I was not expecting this option. It is so hard to make these "sudden" decisions. Having this group as a resource has been TREMENDOUS!
 
Hi Leigh,

I'm reading through latest info. At first glance I'm concerned about your vet's approach: if a cat's ketones are high that's what makes them feel awful and not want to eat. Also if the ketones aren't dealt with the cat will tip over into DKA.

While I'm reading,
Leigh B said:
She did not check his ketones this morning. She said her main concern is getting him to eat. She feels certain they are probably still pretty high. He has only had one unit of insulin since Saturday morning.
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There is something very wrong here. The core treatments for a cat throwing ketones are calories AND insulin. A vet competent in the treatment of ketosis / DKA should know this and treat accordingly.

.* Is there any way you could check whether the ER vets gave Murphy any insulin overnight?

* Also are there any other veterinary practices near you?

E-tubes sound much worse than they are in reality. Great for getting food and meds into poorly kitties. They save lives.

BRB when I've read through the most recent info.


Mogs
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Critter Mom said:
Hi Leigh,

I'm reading through latest info. At first glance I'm concerned about your vet's approach: if a cat's ketones are high that's what makes them feel awful and not want to eat. Also if the ketones aren't dealt with the cat will tip over into DKA.

While I'm reading,

There is something very wrong here. The core treatments for a cat throwing ketones are calories AND insulin. A vet competent in the treatment of ketosis / DKA should know this and treat accordingly.

.* Is there any way you could check whether the ER vets gave Murphy any insulin overnight?

* Also are there any other veterinary practices near you?

E-tubes save lives. Sound much worse than they are in reality. Great for getting food and meds into poorly kitties. They save lives.

BRB when I've read through the most recent info.


Mogs
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Yes, the ER gave him a LITTLE insulin (1 unit). They've got him on IV fluids and are checking his BG. I was concerned about that, as well. That is how I understand things (insulin=lower ketones=increased appetite). I explained to the vet that I am concerned that he's not had much insulin since Sat. am.

Everyone seems to agree that the tube is not as daunting as it sounds.
If it is possible to do that and get him back to a "normal" place, I will not hesitate.
My concern is putting him through that and him not recovering. In other words, I don't want to put him through it if it will not do any good.
The vet is going to call me to discuss the details before the procedure. She said she understands me weighing my options, but that he does not need to go much longer without any food. She said much longer will result in increased medical complications.

Yes, I will consult my usual vet, once I get him home.
 
From the Dr. Pierson link:

Unfortunately, when most people hear the term “feeding tube,” they tend to panic – feeling like this is the end of the road for their cat. However, feeding tubes should not necessarily be viewed as a doom and gloom overly heroic measure.

I often hear people say “oh, I would never put my cat through that!”

Unfortunately, these folks are not recognizing the tremendous value of feeding tubes to support ill patients while they heal from a temporary illness or injury. Most cats are not bothered by the tubes at all! The human is the one who is bothered by it as the cat just goes about its daily routine.​


Mogs
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I agree with Mogs; it sounds like there's more that could/should be done by the vet. I hope your conversation clarifies what's going on and the options.

Hang in there. These things always seem to arise suddenly and change rapidly, making it hard to figure out the best course of action. That's so hard to deal with on top of the emotions when your little guy is sick... We'll help as much as we can with info and ideas :bighug: :bighug: :bighug:
 
He is at the regular vet clinic. She is going to try another type of food and call me in about an hour. I'm going to get the full rundown on his levels and all of that before she proceeds with the feeding tube.
Once I get him stable and at home, I'm going to get a second opinion from the vet I usually see. unfortunately, my typical clinic is not open on Sundays, so I had to go to my previous vet clinic.
Hoping we will not need to go back to the ER at all during any of this
 
Leigh B said:
That is how I understand things (insulin=lower ketones=increased appetite). I explained to the vet that I am concerned that he's not had much insulin since Sat. am.
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You are correct in your understanding, with the additional proviso that the cat also needs calories in addition to the insulin.

You are right to be concerned.

If cat is not in DKA then fluid therapy along with aggressive insulin treatment - typically including use of rapid-, short-acting insulin - is needed to get glucose into the cells and drive down ketone production. This needs to be done in a hospital setting with the kitty on a dextrose drip to prevent hypoglycaemia. At the same time all efforts need to be made to control nausea and stimulate appetite in order to get the calories needed to stop ketone production into the cat. If the meds alone aren't sufficient to restore appetite then a feeding tube is the best next step.

If cat is in DKA then, in addition to the above, intensive treatment and monitoring are needed to correct electrolyte and acid-base imbalances and restore normal metabolic function.

Intensive treatment as described above is not something that can be done at home.

If the feeding tube is placed it should make the continuing treatment needed at home much, much more reliable and successful. You'll be able to ensure that Murphy gets the food he needs. This in turn means that it will be much more straightforward and safe to administer the insulin he also needs to stabilise normal metabolism and aid recovery. The feeding tube will also make it very straightforward to give Murphy any anti-nausea and appetite stimulant meds he needs to help him along the way to eating normally on his own again.

Note: Ketosis and DKA arise due to the following:

Not enough food + not enough insulin + infection, inflammation, or other systemic stressor.​

In addition to getting food and insulin into Murphy, the vets also need to identify what is causing the third problem, i.e. checking for infection/inflammation - dental? UTI? other? - and treating the problem. Please ask them about this.

Another thing to check for is whether Murphy might be constipated. If he became dehydrated before you took him to the vets there is the possibility of constipation. If a cat is constipated then anti-nausea and appetite stimulant meds won't work properly (for obvious reasons). Treatment of the constipation can be a help towards restoring normal appetite (possibly with a few days' treatment with a prokinetic like metoclopramide to improve gut motility).

As I said above, ketosis/DKA is a treatable condition. It's like a 'metabolic hiccup', albeit a serious one. With timely and appropriate veterinary treatment, cats can and do go on to make a complete recovery from it. As you posted above, Murphy's recent labs were very good just a week and a half ago and he was happy and playing like a kitten only a couple of days ago. That sounds to me like a kitty with a whole lot of living left to do! :) With ketones high, Murphy is probably severely lethargic at the moment and that's quite scary to see. (((Leigh))) However, Murphy is young and cats are extraordinarily resilient little creatures. I am in awe of their powers of recovery. All going well, with the right treatment he will again be back to his happy, playful self.

Keeping you both in my prayers. Please keep us updated with Murphy's progress and shout for any help you need.

(((Murphy and Leigh)))


Mogs
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Critter Mom said:
You are correct in your understanding with the additional proviso that the cat also needs calories in addition to the insulin.

You are right to be concerned. However...

If cat is not in DKA then fluid therapy along with aggressive insulin treatment is needed to drive down the ketones - needs to be done in a hospital setting with the kitty on a dextrose drip to prevent hypoglycaemia. At the same time all efforts need to be made to control nausea and stimulate appetite in order to get the calories needed to stop ketone production into the cat. If the meds alone aren't sufficient to restore appetite then a feeding tube is the best next step.

If cat is in DKA then in addition to the above intensive treatment and monitoring is needed to correct electrolyte imbalances and restore normal metabolic function. This is not something that can be done at home.

If the feeding tube is needed it will make the continuing treatment needed at home much, much more reliable and successful. You'll be able to ensure that Murphy gets the food he needs. This in turn means that it will be much more straightforward and safe to administer the insulin he also needs to return his metabolism to normal. The feeding tube will also make it very straightforward to give Murphy any anti-nausea and appetite stimulant meds he needs to help him along the way to eating normally on his own again.

Note: Ketosis and DKA arise due to the following:

Not enough food + not enough insulin + infection, inflammation, or other systemic stressor.

In addition to getting food and insulin into Murphy, the vets also need to identify what is causing the third problem, e.g. checking for infection/inflammation - dental? UTI? other? - and treating the problem. Please ask them about this.

Another thing to check for is whether Murphy might be constipated. If he became dehydrated before you took him to the vets there is the possibility of constipation. If a cat is constipated then anti-nausea and appetite stimulant meds won't work properly (for obvious reasons). Treatment of the constipation can be a help towards restoring normal appetite (possibly with a few days' treatment with a prokinetic like metoclopramide to improve gut motility).

As I said above, ketosis/DKA is a treatable condition. It's like a 'metabolic hiccup' albeit a serious one. With timely and appropriate veterinary treatment, cats can and do go on to make a complete recovery from it. As you posted above, Murphy's recent labs were very good just a week and a half ago and he was happy and playing like a kitten only a couple of days ago. That sounds to me like a kitty with a whole lot of living left to do! :) With ketones high, Murphy is probably very lethargic at the moment and that's quite scary to see. (((Leigh))) However, Murphy is young and cats are extraordinarily resilient little creatures. I am in awe of their powers of recovery. All going well, with the right treatment he will again be back to his happy, playful self.

Keeping you both in my prayers. Please keep us updated with Murphy's progress and shout for any help you need.

(((Murphy and Leigh)))


Mogs
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You have brought tears to my eyes. Thank you for the kind words and guidance.
I have made notes for the vet and will let you know what she says.
Thank you!!!!!:bighug:
 
Leigh B said:
He is at the regular vet clinic. She is going to try another type of food and call me in about an hour. I'm going to get the full rundown on his levels and all of that before she proceeds with the feeding tube.
Once I get him stable and at home, I'm going to get a second opinion from the vet I usually see. unfortunately, my typical clinic is not open on Sundays, so I had to go to my previous vet clinic.
Hoping we will not need to go back to the ER at all during any of this
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Is your vet going to run more blood work today? Please get them to check Murphy's electrolytes before you take him home to make sure he's not in DKA and that he is negative for ketones. If ketones are still high - quadruply so if the electrolytes are also out of whack - then Murphy needs to be in a hospital where the vets know how to properly treat ketosis/DKA and can provide the intensive insulin, fluid and electrolyte therapy necessary to return Murphy's metabolism to normal (as outlined in one of my earlier posts above).

I'd also suggest that you purchase a blood beta ketone meter for home use. The strips are pricey but you would be able to test Murphy for ketones at any time, as easily as testing blood glucose levels (using the ear). Ketones are detectable in blood sooner than in urine. It's a good safety measure.


Mogs
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Hi @Leigh B :bighug::bighug::bighug: First lots of hugs to you and Murphy :bighug:

Here to share about our feeding tube - Jax had an esophagostomy tube (e-tube). At the time, he was dealing with a severe infection (infected ulcer, suspected sepsis, low potassium) - the ER admitted him and transferred him to the internal medicine team - the internal med team did the e-tube. His records say he was on Hills a/d for food (which makes sense now that I've been on this board - it's super easy to water down and syringe feed). His tube was in for about 3 weeks but I only used it for feeding for about a week (rest of the time was his cocktail of meds) - we fed e-tube and then always offered food out too - one day, he started eating the food out.

So, in summary, I pushed food, water, and meds down the tube. I flushed it with water every time I pushed something down - I never remember it being dirty or gunky; the IM would check on it too at his follow-ups; I personally never had to do anything with the stoma site (where it entered his esophagus).

After Jax started eating food on his own, I still pushed extra mls of water as well as his meds. I would totally get one again if he needed it and was stable for it. I totally think it helped save him - it gave him energy to heal and helped him accept the meds we were throwing at him.

Here's a pic of Jax eating with his tube in place as well as his kitty kollar (and all of his water and food choices...ugh he was so sick here but on his way up).

Hang in there :bighug::bighug::bighug: Try to trust you'll make the best decision for you and your kitty no matter what it is. We all do the best we can :bighug:

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Just spoke with her. She said he is pretty bad right now. His BG is at 500, so they're giving him insulin. They are also about to do the tube insert.
They are going to feed him and observe/monitor him overnight (at their clinic, not the ER). I talked with her about my concern that he's not gotten insulin. She said he REALLY needs food right now. She's concerned about hepatic lipidosis (sp?)...I am about to research that. She said they are giving him insulin right now, but giving insulin with no food since Saturday am (that he threw up) could cause more problems- it is a delicate balance, etc.

Any thoughts there? (on the lipidosis??)

It was a sad conversation for me. She said that we need to discuss the feeding tube as an option, or move on to the hard discussion about euthanasia (because of his current state- said he is obviously lethargic and in a depressed state).
I told her, again, that 12 days ago he had a good blood panel and Thursday was very active. It does not make sense to me that he is this bad.
We discussed the success of the feeding tube (I know that no promises can be made that it will work), and she said that one of the vets there had one for his cat recently.

Your posts have helped me feel like I am doing the right thing, and that he will be able to handle it. Hopefully, it will be days/weeks, and not months before he is eating again. It has NEVER been an issue. In fact, I've had to closely monitor his food choices b/c he eats so much.

At this point, he is at the vet and she is moving forward with the procedure. She said they'll try to feed him within the hour of him waking up. They are going to keep him overnight and monitor his blood, urine, etc. before sending him home to me.

It is frustrating to me, too, to have to leave him there. He is a cat who stresses more than cats I have had in the past. Ready to get him home and comfortable. And, I can't go in the clinic b/c of Covid.

Anyway, I am rambling because I am nervous and exhausted.
Thank you all for the great information, love and prayers...

I will post updates.
It is hard knowing that he is struggling so much right now. I hope I am doing the right thing. :(
 
:bighug: :bighug: :bighug: :bighug:

He's relatively young, and starting from a strong base, even if he's in a weakened state right now. Hopefully, that will see him through.

I wonder if keeping him overnight is really necessary? As I said, I've never had a cat with an e-tube, so I don't know what is standard procedure here.

Fingers and paws crossed here, please update us when you can.
 
Leigh B said:
She said they are giving him insulin right now, but giving insulin with no food since Saturday am (that he threw up) could cause more problems- it is a delicate balance, etc.
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That's why cats with ketones should be given IV dextrose so that they can receive insulin safely while they're having difficulty eating. (Insulin should not be withheld from cats throwing ketones: it's a cornerstone of the treatment.)

Leigh B said:
She said he REALLY needs food right now.
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He needs both food AND insulin to fight the ketones. I'm relieved to hear that they've finally given some.

Leigh B said:
She's concerned about hepatic lipidosis (
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Due to the nature of a cat's metabolism, if it goes without food for any length of time fatty deposits start to build in the liver (hepatic lipidosis, potentially life-threatening but also preventable/treatable if the cat gets timely help with nutritional support). This is the reason why it's critical for a cat having difficulty eating due to nausea to get strong enough anti-nausea treatment straight away - possibly with additional support from an appetite stimulant - to help them to eat again. An appetite stimulant on its own is extremely unlikely to work. If the meds don't work fairly quickly to help the cat start eating under its own steam then a feeding tube is the right course of action to take. As Dr. Pierson advises in the page I linked earlier, if the meds don't work quickly it's better not to delay placing a feeding tube.

Leigh B said:
They are going to keep him overnight and monitor his blood, urine, etc. before sending him home to me.
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I'm very glad to hear that Murphy's going to be intensively monitored. Tomorrow, when you're collecting Murphy, I suggest asking for a copy of his blood and urine test results for your own records.

Before you take him home, please, please make sure that the vet gives you an adequate supply of anti-nausea meds (ondansetron, Cerenia). It's so important to have these meds at home to support adequate food intake during the recovery period and prevent relapse. See the section on nausea control in the following document for details of appropriate treatments for feline nausea:

IDEXX Pancreatitis Treatment Guidelines

Although the document's focus is on pancreatitis, the treatments described are also applicable for nausea due to other conditions, including ketosis and DKA. It's a good guide as to what to ask the vet for.

Did the vets say anything about infection/inflammation, and did they double-check that Murphy's not constipated?

ETA: What treatment has the vet been giving for nausea? Is Murphy getting the anti-nausea meds often enough? (Ondansetron at an appropriate dose can be given every 8 hours.)

Also, did the vet test for pancreatitis to rule it out? (Sorry, should have thought to suggest this earlier: diabetes and pancreatitis often travel together.)



Mogs
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