COOKIE - THREAD 3 (6/21/21) STILL "HI"

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pstanfield

pstanfield

Member Since 2021
Starting a new thread on Ms. Cookie. I updated her chart. Still HI at +3, looking punky, laying by water dish, no appetite. Ate a few bites this morning, but no interest now. No interest in the toppers either. Did test for ketones (urine) and still shows neg. Very concerned, at what point do I bring her to the vet? Should I syringe feed? Gave Cerenia, but not sure it helped.

History and Progression:
 
Hmm poor girl. I would definitely syringe feed what you can, food and water. Is she on any pain meds?

I'm a little concerned she was looking up then got worse. Did you say you have an appointment today anyway for the stool sample? It's possible she needed more antibiotics. My gut is telling me something isn't quite right still internally, not ER worthy but definitely seen today if you can.
 
FrostD said:
Hmm poor girl. I would definitely syringe feed what you can, food and water. Is she on any pain meds?

I'm a little concerned she was looking up then got worse. Did you say you have an appointment today anyway for the stool sample? It's possible she needed more antibiotics. My gut is telling me something isn't quite right still internally, not ER worthy but definitely seen today if you can.
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Not on any pain meds. She is now hiding under my bed, and peeing outside the litter box, which is not a good sign. She hasn't pooped today, so I still don't have a sample, but going to bring her in for a check and fluids. I am wondering about the antibiotics as well.
 
pstanfield said:
Not on any pain meds. She is now hiding under my bed, and peeing outside the litter box, which is not a good sign. She hasn't pooped today, so I still don't have a sample, but going to bring her in for a check and fluids. I am wondering about the antibiotics as well.
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Poor Cookie. :( was she tested for a UTI
 
I would see if you can get pain meds. Pancreatitis is painful, so I assume triaditis may be as well.

Yes I would bring her in to be safe, poor girl. I suspect the inflammation isn't resolved, hopefully nothing more serious than that.
 
Weight down to 3.13lbs, she had a fever, so going back to Clavamox. Stopped Clavamox on Saturday. Neg. for helicobacter, but positive for clostridium. However, seems that the FortiFlora and probiotic are starting to work, her stool was not watery and was more a pudding consistency. Teeth are good. BG 416 at +8.

Given SQ fluids and Vit. B, and zofran.

As a BG test, my meter said HI and vet meter said 570. Wondering if my meter is off???? Feeling discouraged, I'm going to need to start syringe feeding.
 
pstanfield said:
Weight down to 3.13lbs, she had a fever, so going back to Clavamox. Stopped Clavamox on Saturday. Neg. for helicobacter, but positive for clostridium. However, seems that the FortiFlora and probiotic are starting to work, her stool was not watery and was more a pudding consistency. Teeth are good. BG 416 at +8.

Given SQ fluids and Vit. B, and zofran.

As a BG test, my meter said HI and vet meter said 570. Wondering if my meter is off???? Feeling discouraged, I'm going to need to start syringe feeding.
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Aw poor girl is having a rough go :bighug: good call taking her in.

If I remember correctly, the ReliOn Prime says HI over 600? Or 650? That's close enough if you take meter variance into account. They get worse at higher numbers, but the actual number itself doesn't matter. Just that she's very high.

Some of that weight was probably due to dehydration. Do you know what her ideal weight is? I'm trying to think if there's high calorie/ low carb food we can give her @Butters & Lyla @PerfumedCatMom you two are food gurus, anything come to mind?

I'm not sure what to recommend for tonight. I'm not sure if infection is keeping her high or she's bouncing, probably a combination of both.
 
Is that 416 after the vet? I'm so hoping she comes down a bit for PMPS that'll make it a little easier to decide what to do.
 
FrostD said:
Some of that weight was probably due to dehydration. Do you know what her ideal weight is? I'm trying to think if there's high calorie/ low carb food we can give her @Butters & Lyla @PerfumedCatMom you two are food gurus, anything come to mind?
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I'm so sorry Cookie is still going through such a hard time. At this point anything Cookie will eat is the most important thing. I know Hill's A/D is a high calorie canned food that kitties love so it's often recommended for syringing but not low carb at all. Also Royal Canin Recovery. Is Cookie motivated by fish? Not great to feed long term but any canned tuna, mackerel or sardines in water with no salt are enticing treats for inappetent kitties that are low carb. Gerber's Stage 2 ham baby food is also a perennial favorite, especially if you're syringing.
 
PerfumedCatMom said:
I'm so sorry Cookie is still going through such a hard time. At this point anything Cookie will eat is the most important thing. I know Hill's A/D is a high calorie canned food that kitties love so it's often recommended for syringing but not low carb at all. Also Royal Canin Recovery. Is Cookie motivated by fish? Not great to feed long term but any canned tuna, mackerel or sardines in water with no salt are enticing treats for inappetent kitties that are low carb. Gerber's Stage 2 ham baby food is also a perennial favorite, especially if you're syringing.
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Thank you! I was hoping to keep low carb because of the recent DKA. It's a tricky thing to balance. But she definitely needs to get some weight on.

I know Mr kitty loves the Gerber 2nd Foods meats, I keep those on hand for syringing.

@Sienne and Gabby (GA) @Wendy&Neko thoughts here?
 
pstanfield said:
Weight down to 3.13lbs, she had a fever, so going back to Clavamox. Stopped Clavamox on Saturday. Neg. for helicobacter, but positive for clostridium. However, seems that the FortiFlora and probiotic are starting to work, her stool was not watery and was more a pudding consistency. Teeth are good. BG 416 at +8.

Given SQ fluids and Vit. B, and zofran.

As a BG test, my meter said HI and vet meter said 570. Wondering if my meter is off???? Feeling discouraged, I'm going to need to start syringe feeding.
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The infection is keeping those numbers high. If still high tonight is probably day go back to 1.25. I'm glad her poop is better
 
Any chance you can get some ondansetron? It's a human med, but you get the prescription from the vet. It's often much better than Cerenia for nausea, and it does sound like that is one of the issues.
 
I like Ziwipeak Lamb for low carb but calorie dense. I also use Almo Nature Natural Chicken Drumstick in Broth (all dark meat chicken) and Almo Nature Natural Mackerel in Broth for Butters. These are higher in calories than something like tuna or chicken breast, as they are fattier. But you can't feed them long term as they are not nutritionally balanced and are only meant for intermittent feeding.

I hope your sweet Cookie feels better soon:bighug:.
 
FrostD said:
Aw poor girl is having a rough go :bighug: good call taking her in.

Do you know what her ideal weight is?
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Around 8 pounds is her ideal weight. She was given Ondansetron in house, and the vet gave me a script for her, I just need to pick it up at the pharmacy. So that's good! I was given some high calorie food for syringing, it's Purina CN, vet also recommended the baby foods and Royal Canin Recovery, if I can find it. I will try a variety, but really hoping she starts to eat on her own again once the Vitamin B and Ondansetron kick in. Thanks for all the recommendations!!! Her 416 was post-vet. I'll test soon so we can see where we are.
 
pstanfield said:
Around 8 pounds is her ideal weight. She was given Ondansetron in house, and the vet gave me a script for her, I just need to pick it up at the pharmacy. So that's good! I was given some high calorie food for syringing, it's Purina CN, vet also recommended the baby foods and Royal Canin Recovery, if I can find it. I will try a variety, but really hoping she starts to eat on her own again once the Vitamin B and Ondansetron kick in. Thanks for all the recommendations!!! Her 416 was post-vet. I'll test soon so we can see where we are.
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Ok thanks!

Let us know what you're able to feed, and ideally the carb %. She needs to gain weight, higher carb is ok so long as we can balance it with insulin dose. Will be tricky.
 
Butters & Lyla said:
I like Ziwipeak Lamb for low carb but calorie dense. I also use Almo Nature Natural Chicken Drumstick in Broth (all dark meat chicken) and Almo Nature Natural Mackerel in Broth for Butters. These are higher in calories than something like tuna or chicken breast, as they are fattier. But you can't feed them long term as they are not nutritionally balanced and are only meant for intermittent feeding.

I hope your sweet Cookie feels better soon:bighug:.
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You are awesome thank you!
 
FrostD said:
Ok thanks!

Let us know what you're able to feed, and ideally the carb %. She needs to gain weight, higher carb is ok so long as we can balance it with insulin dose. Will be tricky.
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I've been feeding her the Purina CN with syringe, so I have the amounts covered for the next three days. She is getting 41 mls today, 83 mls tomorrow, and 125 mls the third day (maintenance for current weight), if needed. Start going higher after that. The goal is to get her eating on her own again before maintenance. This is based on Purina CN, undiluted.

Right now her BG is 410 at +11.
 
Right now most of my food is 3-4% carb, except what is in the HYPO kit. That's all 24%, rx stuff. Purina CN is at 9% carbs, so I say we stick with anything less than 10% still.
 
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I have to dose her. I am going to give her 1u. Id I need to do more, can I add more? I have to get to the pharmacy and I am 30 minutes past her dose.
 
i gave her a fat 1u, and I think I gave a fur shot or it went out the other side, I can smell the medicine on my hands. I can't believe this.
 
She is laying down with her head over her water bowl, making small, constant grumbling sounds. This is killing me.
 
pstanfield said:
Right now most of my food is 3-4% carb, except what is in the HYPO kit. That's all 24%, rx stuff. Purina CN is at 9% carbs, so I say we stick with anything less than 10% still.
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9% is perfect. Stick with that until her weight comes back up. If you plan on changing food please please let us know, because that impacts dosing (and risks a hypo if not careful).
 
pstanfield said:
I have to dose her. I am going to give her 1u. Id I need to do more, can I add more? I have to get to the pharmacy and I am 30 minutes past her dose.
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I think this was a good call. She got more fluids and antibiotics today, and is coming down a bit. Last time they seemed to work pretty quickly on her and brought BG down.
 
pstanfield said:
i gave her a fat 1u, and I think I gave a fur shot or it went out the other side, I can smell the medicine on my hands. I can't believe this.
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It happens to the best of us, don't worry. Take a deep breath!

No, never give extra or another dose after a fur shot, or if you don't like the numbers. You don't know how much got in and how much that will affect her BG; in the case of giving extra later, you end up with two onsets and two nadirs to contend with and can get very ugly very fast.
 
I know you've been through a lot, but I would really press the vet for pain meds, most of us use gabapentin or buprenorphine. Sounds like she's in pain, and all the nausea meds in the world won't help that.

Just keep doing what you're doing with the syringing. Sometimes tuna water or a little gravy mixed in the water will motivate her to drink. I know it's heartbreaking to watch, just hang in there. Last pancreatitis flare, Mr kitty was doing the same thing and panting.

Tomorrow when you're fresh, it will help us to know what meds she's getting, in what dose, and when. If you look at Butters spreadsheet up above, that's a good example.
 
FrostD said:
I know you've been through a lot, but I would really press the vet for pain meds, most of us use gabapentin or buprenorphine. Sounds like she's in pain, and all the nausea meds in the world won't help that.

Just keep doing what you're doing with the syringing. Sometimes tuna water or a little gravy mixed in the water will motivate her to drink. I know it's heartbreaking to watch, just hang in there. Last pancreatitis flare, Mr kitty was doing the same thing and panting.

Tomorrow when you're fresh, it will help us to know what meds she's getting, in what dose, and when. If you look at Butters spreadsheet up above, that's a good example.
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Ok I'll update with meds tomorrow and take a look at Butters SS. I'll talk to the vet about pain meds. This is the first time I've heard her moaning/groaning, that is really hard to hear. She is drinking her water, it is hard not to, since her chin is literally resting in the bowl. :(

Going to test at +3 and see where we are.
 
pstanfield said:
Ok I'll update with meds tomorrow and take a look at Butters SS. I'll talk to the vet about pain meds. This is the first time I've heard her moaning/groaning, that is really hard to hear. She is drinking her water, it is hard not to, since her chin is literally resting in the bowl. :(

Going to test at +3 and see where we are.
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Sounds like a plan. My testing guidance from yesterday still holds.

Just remember honey/karo (hopefully you don't need it) wears off quickly, so always give wet food with it and retest in 20 mins after giving it.

Is there anyone that can help you out with testing so.you can get a break? Are your kids old enough?
 
FrostD said:
Sounds like a plan. My testing guidance from yesterday still holds.

Just remember honey/karo (hopefully you don't need it) wears off quickly, so always give wet food with it and retest in 20 mins after giving it.

Is there anyone that can help you out with testing so.you can get a break? Are your kids old enough?
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Kids are old enough, but my boys have to be up early for cross country and my daughter is working this summer to make money for college, she just graduated H.S. She also panics at the sight of blood and needles. It's pretty much just me. At least they are old enough to make some meals. Looked over guidelines from last night.
 
I'm sorry she's in so much pain. :( As long as you can keep an eye on her id do a fat 1 for a while
 
I'm also thinking a fat 1 this morning to see how she does/of the antibiotics kick in like they did last time, though I suspect we may need to increase it tonight.
 
FrostD said:
I say yes. She's been coming down overnight, but not too fast, good sign!

How's she feeling/acting?
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Feeling better, not sure how fast the zofran works, but within 20 min of zofran with syringe feeding, she was starting to eat on her own. Could be combo of Zofran and avoiding syringe. Vet told me to hold off on syringe while she eats on her own (FF LC), then resume about an hour later. She's been purring some, especially while brushing her. She's resting more next to her water bowl, and less with her head in the bowl, on top of the water. I'll be giving her 100 mL SQ fluids about 2 pm (+ 6; same time as yesterday), my first time solo.
 
PerfumedCatMom said:
I'm so sorry Cookie is still going through such a hard time. At this point anything Cookie will eat is the most important thing. I know Hill's A/D is a high calorie canned food that kitties love so it's often recommended for syringing but not low carb at all. Also Royal Canin Recovery. Is Cookie motivated by fish? Not great to feed long term but any canned tuna, mackerel or sardines in water with no salt are enticing treats for inappetent kitties that are low carb. Gerber's Stage 2 ham baby food is also a perennial favorite, especially if you're syringing.
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So the Gerber Stage 2 foods (Ham, Beef, Chicken), does it say "Ham/Beef/Chicken with Gravy" or just the meat? I could only find some that said "with gravy".
 
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pstanfield said:
So the Gerber Stage 2 foods (Ham, Beef, Chicken), does it say "Ham/Beef/Chicken with Gravy" or just the meat? I could only find some that said "with gravy".
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They say gravy, I thought the same thing when I first bought them. Those are the ones you want
 
pstanfield said:
So the Gerber Stage 2 foods (Ham, Beef, Chicken), does it say "Ham/Beef/Chicken with Gravy" or just the meat? I could only find some that said "with gravy".
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All of these are fine to feed. Also Beechnut meat only foods are good, but from what I know, kitties tend to prefer the Gerbers.
 
Poo is looking way better, more formed, still soft, but improving. Better than squirty and watery. I think the probiotics are starting to kick in. BG numbers are going up though.
 
If the antibiotic is a liquid, is there any chance the clavamox is in a sugar solution base?

Any infection/inflammation will cause numbers to be high. It's also possible that what you're seeing is a bounce off of the string of greens on 6/19 and 6/20. It can take roughly 3 days for a bounce to clear.
 
Yes, we definitely are fighting inflammation and just got back on Clavamox after being off for two days. It is a liquid, but not sure if it is a sugar solution.
 
If it's from your vet, ask. If you had it filled at a compounding pharmacy, call them. It's amazing that they often don't realize that the cat is diabetic and they put the antibiotic in a sugar solution to offset the bitterness of the antibiotic. It happens fairly often.
 
Sienne and Gabby (GA) said:
If it's from your vet, ask. If you had it filled at a compounding pharmacy, call them. It's amazing that they often don't realize that the cat is diabetic and they put the antibiotic in a sugar solution to offset the bitterness of the antibiotic. It happens fairly often.
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Called the ER, they said it doesn't say on the box, they get it already compounded and that I should call the company. o_O You'd think if you prescribe something, you'd know what was in it? I'm guessing just from the sweet smell of it that it is in a sugar base. Going to see if I can contact the company now....
 
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