*+10 BG reading "HI" + 598* what do I do? Agatha isn't eating AGAIN!

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AggyBear

AggyBear

Member Since 2021
I'm at such a loss. This is the third time she has over the course of 2 or 3 days gotten nauseous and stopped eating and mostly stop drinking since she was diagnosed in January. She's definitely lost weight. This is day 4 with almost nothing. She's managed to get several treats down yesterday but nothing since.

Can y'all please look at her chart and see if there's any pattern or telltale signs that maybe the cause of this? If in my power I want to prevent it. Been giving her Cerenia + Mirataz the last 3 days.

Does anyone have trouble like this, like Aggy + I do?
 
Why have you stopped giving her insulin.?
Are you testing for ketones in the urine.? This is very important if you are skipping doses of insulin.
If you do not have any Ketostix please go out and buy some now and test the urine for ketones.

Has Agatha been tested for pancreatitis? A fPL test is needed.
 
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I haven't been giving insulin bc either 1) she was below 200 and that's the "no shoot number" or 2) she hasn't eaten anything. Is this the right way to handle that situation?

We've been through 2 previous cases of hepatic lipidosis + subsequential feeding tubes. I don't know if her health can handle another one?
Bron and Sheba (GA) said:
Are you giving the cerenia before the Mirataz?
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Is there a particular timing for this? Like giving the anti-nausea and then a certain amount of time later give the appetite stimulant? The vet only said to give both once a day.

I have a box of the
Bron and Sheba (GA) said:
Has Agatha been tested for pancreatitis? A fPL test is needed.
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No. But I did get a box of the urine testing strips 2 months ago. I need to find out how to use them,

Thanks in advance for your help! -Sammy + Aggy
 
AggyBear said:
I haven't been giving insulin bc either 1) she was below 200 and that's the "no shoot number" or 2) she hasn't eaten anything. Is this the right way to handle that situation?

We've been through 2 previous cases of hepatic lipidosis + subsequential feeding tubes. I don't know if her health can handle another one?

Is there a particular timing for this? Like giving the anti-nausea and then a certain amount of time later give the appetite stimulant? The vet only said to give both once a day.

I have a box of the

No. But I did get a box of the urine testing strips 2 months ago. I need to find out how to use them,

Thanks in advance for your help! -Sammy + Aggy
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Insulin is needed for other things apart from reducing the blood glucose. Not giving any insulin is taking a risk of ketones forming.
I’m not a Prozinc user so don’t like to say how much to give so I’ll tag @Deb & Wink and @JanetNJ
You have been giving insulin long enough to be able to reduce the no shoot number.
If you get a number under 200.....stall, dont feed and post and ask for help. And test in 20 minutes.


You also need to address the problem of Agatha not eating.
You need to give the cerenia at least an hour before the appetite stimulant.
You may need to get some a/d from the vet as it is easy to syringe feed. I would get onto this straight away before more problems arise from not eating.

If you have a bottle of Ketostix, you need to collect a urine sample rom Agatha. Then dip the test strip into the urine and read it exactly 15 seconds later against the colours on the side of the bottle. Please post any result from that. Anything above a trace is of concern and you will need to contact your vet.

The pancreatitis test is quite seperate to the ketones test. the vet needs to do the pancreatitis test but you can do the ketone test.
If the pancreatitis test is positive that would explain the loss of appetite and a treatment could be started.
 
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So sorry to hear about poor Aggy not eating. It is such a massive worry and you feel so helpless.

I have a constant battle with that as Pabay has waxing and waning pancreatitis. When I have major problems and I have no option but to get food in him I mash up his favourite food with warm water and put it in a 5ml entirely plastic syringe (not one with a needle). I cut off the top of the tip of the syringe if it is too narrow. I do not syringe it down his throat I syringe a blob or drip just inside his gums on his lower lip frequently. I don't restrain him so as not to stress him. The anti-sickness helps him keep down what little I can get into him.

My life saver has been purina fortiflora pro-biotic. It has a smell or something that stimulates Pabay's appetite. It is the same stuff they put on kibble to make it attractive to cats.

Don't be phased by the urine strips. Just dunk the tip in (in a well lit room), set the stop watch and read the colour (and repeat to be sure).
 
I called and am going to pick up the a/d food right now! I will do my best with the syringe feeding. My poor baby is traumatized from doing this in the past but I'm going to try.

I did give the Cerenia probably 2 hours before I gave Mirataz last night. I will continue to give Cerenia at least an hour before the Mirataz now.

I have some of the Purina Fortiflora pro-biotic.

I will do my best with the syringe feeding, if anyone can guide me with the no shoot number I would greatly appreciate it. This is a lot + I'm so thankful to have y'all!
 
Is pancreatitis diagnosed with blood test + ultrasound? I want to help her but am limited financially. This is all scary. Thank you for your kind words! Is the pancreatitis secondary to the diabetes?

She is weak, lethargic + feels warm.
 
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I can only talk about what my vet did with pabay in the UK. Pabay got pancreatitis and gallstones. The former damaged his pancreas. Pabay then became diabetic.

Vet did lots of bloods (no idea what except fructosamine) but pancreatitis and gall stones were confirmed on an ultrasound. Others in the US may have different experiences.
 
I just picked Agatha up. Here's what the vet texted me:

Hi Samantha. Agatha's bloodwork is not to bad. Glucose at 259. Kidney values were fine. She weighed 10.8 today. Her last weight was 13.2, so that is definitely down. Her temp was 103.1, which is fever and her cbc showed increased white blood cells, so it seems like she is dealing with infection. I do not find any obvious source for infection- so, has she been coughing, having diarrhea, sneezing, any other outward signs? (I told him no outward signs other than dried nose + crusty eyes and i felt she was warm). I am going to send home Veraflox. This is an oral antibiotic given once daily to cats. It is very broad spectrum. Keep up the insulin as you are, the supportive care such as fluids, cerenia, Mirataz, etc. I don't find anything else very remarkable other than the fever and white count. I don't find any obvious source for the infection. Syringe the a/d if she doesn't eat otherwise. Hope the abx will kick in and stop the fever so she will eat better for you.

So now I need to get home + start the syringe feeding + medications (antibiotics, Cerenia, Mirataz, fluids). I got 8 cans of a/d. He said if she isn't eating on her own in a couple days I'd need to bring her back.

Does anyone know where I can learn about the ProZinc adjusted no shoot numbers?
 
Hi Samantha
Thanks for the update.
I’m glad Agatha has been started on an antibiotic. Be sure she gets is all.
I think it is really important that you restart the insulin. Agatha has the three things for the recipe for DKA which you certainly don’t want her to get.
The recipe is not enough insulin, not enough food and an infection or inflammation. so she is at risk of developing ketones.

So first thing, try and get her to eat as much as you can. Food is very important.
Keep up the antibiotic.
Start some insulin. As I said I am not a Prozinc user so can’t really help you but I do know that she needs to start back on it.
Test at least once a day for ketones in the urine and let us know the result please.

When is the next dose due?

I am going to tag @Deb & Wink and @JanetNJ again and I will also tag @Marje and Gracie

In the meantime here is the link for Prozinc users. https://felinediabetes.com/FDMB/thr...-the-prozinc-basics-please-start-here.164995/

Let me know how the food is going and the next shot is due.
Bron
 
AggyBear said:
Does anyone know where I can learn about the ProZinc adjusted no shoot numbers?
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Those are very individual to each cat, and how your cat is doing on the insulin.

Your SS indicates that Agatha's nose is very dried out and her gums are dried out. Classic signs of serious dehydration. You need to get fluids into her, either sub-q or by adding water to her food ASAP. Or you can try to give some water via a needleless syringe, like a feeding syringe. Be very careful to only give small amounts of water at a time via syringe, and aim it towards the sides of her mouth, so she doesn't aspirate it into her lungs. If you are not sure you would be able to syringe the water into her, then adding water to the food, to make a slurry would be better. That way, she is getting food and water at the same time.

Have you been successful at all with assist feeding her? Do you have more sub-q fluids you can give at home?

A cat not eating (or not eating enough), with an infection, no insulin, not drinking is in very serious trouble. The risk of ketones forming and possibly leading to DKA is very high.

So you should NOT be skipping the insulin right now. She needs some insulin, even if she is not eating. You'll need to monitor her more. You should be monitoring her during the cycle more too, not just the pre-shot tests.

How much insulin does Agatha need? I have no idea. No way to judge that without seeing how far she drops during the middle of the cycle. All I know is that Agatha DOES need insulin, even if she is in the yellow ranges at pre-shot, even if she is in the high blue ranges at pre-shot.
 
If Agatha were my kitty, I’d be giving her 1.5u twice a day for any BG above 90, testing a whole lot more, and syringe feeding her to keep her BG stable. Testing is really critical to keeping her safe and getting as much insulin in her as you safely can. I’d try to get as m any calories in her and I wouldn’t worry about the carbs right now.

You can test her, feed her, and then give insulin so you know food is in her tummy before you shoot. But it’s absolutely critical that you test her often depending on the BG...and that includes at night....so you can keep her safe.

sending tons of healing light for her.
 
Pleased she's home and in the best place. Uti can knock out the effectiveness of insulin in my experience with pabay. Antibiotics should sort infection out. Hope Aggy improves quickly.
 
I got her home yesterday evening, I got about ½ can a/d + water by syringe feeding, 1.5u insulin + the antibiotic. She was miserable but very weak so just let me without much protest. This morning she was walking on the bed to tell me she was needing something (which is huge improvement for only 1 night). She licked at the higher carb Friskies chunks + ate a few Greenies treats so gave another 1.5u insulin + Cerenia. Been at the water bowl, drinking little trickles. Her beard is completely soaked from sitting in the bowl. Gave Cerenia + just tested, BG was 333. I was able to test urine and it was a pink shade between 15/40 or small to moderate traces of ketones. I'm not sure what that indicates. She looks pretty ragged, I know y'all know the look! But I think she's feeling a bit better than yesterday. Thank you all for your kind words + straight forward suggestions. Is there anything I need to do going forward?
Marje and Gracie said:
If Agatha were my kitty, I’d be giving her 1.5u twice a day for any BG above 90
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This is regardless of food intake?
 
Hi Samantha,@AggyBear
I am very concerned Agatha has ketones in the urine.
Please ring the vet straight away and tell him she has a trace/moderate ketones in the urine. This is important. Ketones cannot be ignored.
Ask the vet if you can bring her in to get some subQ fluids and ask him if you can give the subQ fluids at home.
Ketones can progress to DKA very quickly if not treated.

You also need to be doing these things
  • Offer food every 2 hours. If she will not eat syringe feed her. Food is extremely important and helps stop ketones. She needs to be eating 1 1/2 times what she normally eats.
  • It doesn’t matter what she eats at the moment. Dry food is OK. She must eat and often.
  • Don’t skip any insulin doses
  • Test BG at least 2 times during the cycles as well as preshot. More tests if the BG drops
  • Encourage drinking.
  • Test for ketones at least twice a day at the moment
  • Change the subject line to “trace to Moderate ketones in Urine” to alert people.
  • Post frequently with her progress and if you are concerned, we will be watching for updates.
  • You can feed higher carb food to keep the BG higher because giving the insulin is very important. Post and ask for guidance with this if unsure what to do.
 
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I have SubQ I've been using, I keep track of usage in the SS. I was going to give her some this evening but instead just gave 150ml right now. She's eating some pureed higher carb Friskies now.
Bron and Sheba (GA) said:
ask him if you can give the subQ fluids at home.
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He said to give fluids but didn't specify how much daily until she's eating regularly again. How much fluid do you recommend?

I'll scoop the litter box + put the plastic baggy back in there to catch the urine.
 
AggyBear said:
I just picked Agatha up. Here's what the vet texted me:

Hi Samantha. Agatha's bloodwork is not to bad. Glucose at 259. Kidney values were fine. She weighed 10.8 today. Her last weight was 13.2, so that is definitely down. Her temp was 103.1, which is fever and her cbc showed increased white blood cells, so it seems like she is dealing with infection. I do not find any obvious source for infection- so, has she been coughing, having diarrhea, sneezing, any other outward signs? (I told him no outward signs other than dried nose + crusty eyes and i felt she was warm). I am going to send home Veraflox. This is an oral antibiotic given once daily to cats. It is very broad spectrum. Keep up the insulin as you are, the supportive care such as fluids, cerenia, Mirataz, etc. I don't find anything else very remarkable other than the fever and white count. I don't find any obvious source for the infection. Syringe the a/d if she doesn't eat otherwise. Hope the abx will kick in and stop the fever so she will eat better for you.

So now I need to get home + start the syringe feeding + medications (antibiotics, Cerenia, Mirataz, fluids). I got 8 cans of a/d. He said if she isn't eating on her own in a couple days I'd need to bring her back.

Does anyone know where I can learn about the ProZinc adjusted no shoot numbers?
Click to expand...
AggyBear said:
I have SubQ I've been using, I keep track of usage in the SS. I was going to give her some this evening but instead just gave 150ml right now. She's eating some pureed higher carb Friskies now.

He said to give fluids but didn't specify how much daily until she's eating regularly again. How much fluid do you recommend?

I'll scoop the litter box + put the plastic baggy back in there to catch the urine.
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The rule of thumb is 10 ml per pound. You said he was about 10.8 lbs, so I would do 100 ml. per day.
 
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AggyBear said:
Does anyone know where I can learn about the ProZinc adjusted no shoot numbers?
Click to expand...
Hi... So those times you didn't shot she was really close to 200. So let's say you get a number at shot time that's close.... I would stall for up to an hour and retest and see what you get. If it's raised to over 200 go ahead and shoot her regular dose. If it's close but not quite there like 175-200 id reduce a bit... Maybe to 0.75-1... Be more cautious of you can't test. The reason is so important is because infection + poor eating is just begging for ketones.

I used a ketone blood meter. The reason is ketones hit the blood first, and frankly it's more convenient than waiting for them to pee. You use it the same you would a bg meter.
 
Ok, I'll move forward with 100ml fluid daily until she's eating normally. I have no idea where the infection is or what it's from, but with my not giving insulin those chunk of days, did I hurt her pretty badly? Like, did I cause this?

I just got ⅓-½ can of a/d in her syringe feeding + 2nd dose of antibiotics. She's resting now and I'll test, feed and shoot in about 2 hours.
 
AggyBear said:
At 9:46pm BG 359. She is warm to the touch.
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That’s good you got the +11 BG. Looks like she will be fine to get the 1.5 units at PMPS.
Try and get as much food into her as she will tolerate. Think of the food as a medicine when it comes to ketones.
Good idea of Wendy’s to ask for ondansetron.
I’ll be around for the next 7 hours so please keep us updated.
Any luck getting another ketone test yet?
 
As of 12:35am, not enough urine for another test but I hope in the morning she'll have peed again. It appears her appetite is coming back slowly but she is weak. I'm going to try to get some sleep. I have some ondasetron a friend gave me but will need to figure out dosage for her.
JanetNJ said:
So let's say you get a number at shot time that's close....
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This is helpful and I'll refer back to it.

I appreciate + love y'all for your attention + care to help me + my baby girl!
 
AggyBear said:
As of 12:35am, not enough urine for another test but I hope in the morning she'll have peed again. It appears her appetite is coming back slowly but she is weak. I'm going to try to get some sleep. I have some ondasetron a friend gave me but will need to figure out dosage for her.

This is helpful and I'll refer back to it.

I appreciate + love y'all for your attention + care to help me + my baby girl!
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Consider getting a ketone blood meter. They sell them on amazon. Then you don't have to wait for pee. I use the keto MOJO but there are lots of brands
 
Hey there, today was a long day in taking care of Agatha. She felt warm but I took her temperature + it was in the normal range (think 101.8? I'm in bed and don't want to get up to check, I will tomorrow). I have been unable to get a 2nd urine sample. I would like to have the ketone blood meter but I just don't have money right now. All my notes are in the SS. In the little over 48 hours I've seen good improvement, especially today with her appetite + eating more willingly. Just wanted to give y'all an update <3 Sam + Aggy
 
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Thanks for the update Samantha.
I’m so glad you are seeing improvements.
Try and get that urine sample as we need to know what the ketones are doing. That’s important.
How much is she eating do you think?
Are you still having to syringe feed?
Are you able to get any tests in during the pm cycles? Even one would be good. We need to see how low the dose is taking Agatha so we can look at increasing the dose if she doesn’t start to drop a bit lower.
 
@Bron and Sheba (GA) Thank you for messaging me! I had a fragmented morning. I was startled awake when water splashed all over me because Agatha must have tipped it over a couple hours before I was supposed to wake up. I haven't been able to get another urine sample but I keep trying! Every few hours I check + scoop + replace the plastic baggy. Maybe I need to try different method?

Agatha continues to slowly get better. She's been jumping on the bed + laying on the kitchen mat near the counter where I feed her + those 2 things mean "I'm hungry! Feed me!" Also rubbing against the furniture (+ scratching it!!!) shows she's feeling a bit better. Her appetite is returning + nausea I think is subsiding. I found a way to trick her to eat more: 2 days ago she was only wanting to eat these soft Blue Buffalo treats so I got 2 flavors + a bag of Greenies. Since yesterday I've alternated between the 3 kinds + that kinda works. She even started to lick at the Friskies this evening. She got about 60ml a/d at 12:45pm + insulin then. I don't know exactly how much she's eating but I will continue to syringe feed until she's eating fully on her own. My sister helped me take care of her while I was away at work (and will tomorrow too). I'll pick up the food now and test in about 2 hours (will syringe feed if didn't eat on her own). I will aim to get a couple tests in the PM cycle to help determine if she'll need a bigger dose.

I hope this info is helpful in y'all supporting us + suggesting how to move forward. I wish there was a way I could thank you better! -Sam + Aggy
 
Thanks for the update Sam. Just seeing her improve is all the thanks we need!
I’m glad you feel she is improving. Are you continuing with the antinausea and appetite stimulant routinely at the moment?
We really need to see another urine test and see if she still has ketones. That is really important. That is one of the ways we can tell if she is improving and if she needs more insulin.
Are you able to put a large spoon or a small plastic container under her when she pees or even the test strip?

Looking at her BGs they are not coming down at all. I will tag @JanetNJ to see if she thinks we could increase the dose.
Please come back online before you given the dose so we can tell you what to do Sam please re the dose
 
Yes, Cerenia, Mirataz + fluids + antibiotics daily! I will come back before I feed. Will be in about 1½ hours.
Bron and Sheba (GA) said:
Are you able to put a large spoon or a small plastic container under her when she pees or even the test strip?
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Everytime I go to send an update I grimace bc I know this is so important. I will try to make an even bigger area of plastic in the litter box + will keep an eye for her next trip to the box. I've been offering treats + food about every 2 hours and usually she eats a handful of treats.
 
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Yes I will be able to test. I'll feed her now. Just out of curiosity, is your name Bron (is that short for something? Does GA mean general administrator?
 
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