6/8 Bear won't eat :(

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Tami & Bear

Tami & Bear

Member Since 2022
Bear (13) was diagnosed with diabetes on May 19 with mild Pancreatitis at a reading of 8.4.

We had been doing really well at home, got him on new food, testing glucose, getting the BG levels down slowly. Monday I saw readings in the high 100’s (when we started in the low 500’s). I was elated.

Monday night he ate all his wet food at 8:30pm (2oz), half his dry food at 10pm (ate about 2 tbsp)… and that’s the last time he’s eaten. He also was having some loose stool leading up to this. Tuesday morning he refused to eat and then threw up bile. I had to go to work (literally my first day back in after 2 years…) so I did a blood reading, left food out, and only shot 0.5u Lantus (he usually would get 2). When I got home I found stale, clear vomit. My husband was home until 11:30, so it was probably in the afternoon.

So last night I took him to the ER vet. Vet said “if you didn’t tell me what was going on I wouldn’t know why you were here.” Bear was at the front of the cage, being chatty with the staff, a total 180 from his behavior at home (stress related, I'm sure). He got fluids, anti nausea meds, and appetite stimulant, and was sent home to keep an eye on. No discomfort or clear bloating in the belly. I also had them do a blood gas analysis but haven’t heard back yet. Today I brought home every manner of stinky cat food – purees, chunks, pate… I cooked scrambled eggs, which he’s enjoyed in the past. Put a little gravy from the foods on his mouth so he’d have to lick and try it… I got 3 licks of one food out of him and nothing else. This cat in good health will scarf down absolutely anything presented to him and is a total beggar.

I have an appointment with his usual vet at 9am tomorrow and another dose of the appetite stimulant for this evening. What else can I do? In poking around I’ve seen others suggest feeding with a syringe… any ideas where I could pick one up? Also do I call the ER vet and ask if I can have more of the anti-nausea medication? I have (cat) gabapentin at home. Do you think he might be in pain and having a little bit would help, or could that make him more nauseous?
 
Hi Tami - sorry to hear Bear isn't feeling well. One of our members wrote this Primer on Pancreatitis - yes, most definitely if you can get some more anti-nausea meds for tonight, that would be ideal, since eating a few bites then walking away is one of the signs of nausea as is lip licking. Some kitties do fine with gabapentin, but some forum members who have used it don't like the effects, so you might ask your vet for buprenorphine - pancreatitis can be very painful, so addressing the pain is a good idea, since kitties can often hide their pain well. This post on Feline Pain Scale might help you gauge what Bear is up to.

Which anti-nausea meds was he given yesterday evening? I would hold off on the appetite stimulant tonight, and would rather you give him anti-nausea meds for the moment. It's not a good idea to give an appetite stimulant to a cat who is nauseous, it is better to treat the nausea first.

This link offers some Suggestions on How To Stimulate Kitty's Appetite

Tagging Elise @tiffmaxee since she's had quite a lot of past experience with chronic pancreatitis.
 
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Thanks so much for writing me back. The ER put a call in to the vet so hopefully I can get a refill tonight (but no promises unless I dragged him back in for another full eval). I won’t give him the appetite stimulant – he has had at least a passing interest in what I’ve been putting in his bowl today and has been willing to take some licks of puree off my fingers, which tells me appetite isn’t really the issue. He was given mirtazapine last night, about 22 hours ago.

I managed to get one syringe of puree into him just now. I want to give him a break to see if he vomits it up, but fingers crossed. I’ll throw a sprinkle of gabapentin in the next syringe. Bear does ok with it, but only in very small doses, so I’ll tread lightly. Looking at this pain chart I believe he’s been in pain all day, my poor guy </3
 
Noting as well that I see mirtazapine and gabapentin combined can increase drowsiness and confusion, so if I am able to get some tonight I will contentious of the dosage and timing.
 
That's great that you managed to get him to eat a little. Licking small amounts off your finger or from a spoon can work to get them going, as also can a little syringe feeding. Sometimes all it takes is a little coaxing to get them going, then things pick up on their own. Good that you have some experience with the gaba and how Bear does, it's one of those every cat is different things :).
 
If you are finding he still appears nauseous, I wouldn't give him the mirtazapine tonight. Like I mentioned, better to get something to treat the nausea first, like ondansetron or cerenia.
 
Ok. Yeah I was a little perplexed when I looked it up. It says it can treat nausea, but that almost seems like an afterthought. So far he's holding down 2 syringes worth of puree so fingers crossed. I've also been having the WORST time pricking him for readings today (never getting enough blood... usually we do ok at this) but he's due for insulin in 2 hours so I'll wait till the gaba kicks in and bug him then. Trying really hard to balance my annoying him with giving him space today because he's definitely stressed.
 
Tami & Bear said:
Ok. Yeah I was a little perplexed when I looked it up. It says it can treat nausea, but that almost seems like an afterthought. So far he's holding down 2 syringes worth of puree so fingers crossed. I've also been having the WORST time pricking him for readings today (never getting enough blood... usually we do ok at this) but he's due for insulin in 2 hours so I'll wait till the gaba kicks in and bug him then. Trying really hard to balance my annoying him with giving him space today because he's definitely stressed.
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Question for you my kitty has had liquid gabepentin but not pill form. I have gabepentin mini tab 50mg & it says to give 1 tablet 50mg by mouth twice a day. I had another member suggest 25mg to start with & see how that affects him. He weighs 17lbs & I suspect he has pancreatitis. How much do you give your kitty?
 
The gabapentin was prescribed a while back for anxiety, not for this pancreatitis, I just happen to have it. They're 100mg pills and I open then and use the powder at about 20mg at a time. Any more than that and he was completely zonked in a way that didn't look fun. Bear's about the same size as your guy.

I'm not sure what to do now - he just used his box and had liquid diarrhea. Do I continue syringe feeding? I also just tried multiple times to get a BG reading to no avail. The blood doesn't bubble when I stick him, it just seeps out into the fur and I can't pull it onto the strip. This is his normal feeding and injection time.
 
Tami & Bear said:
The gabapentin was prescribed a while back for anxiety, not for this pancreatitis, I just happen to have it. They're 100mg pills and I open then and use the powder at about 20mg at a time. Any more than that and he was completely zonked in a way that didn't look fun. Bear's about the same size as your guy.

I'm not sure what to do now - he just used his box and had liquid diarrhea. Do I continue syringe feeding? I also just tried multiple times to get a BG reading to no avail. The blood doesn't bubble when I stick him, it just seeps out into the fur and I can't pull it onto the strip. This is his normal feeding and injection time.
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Thank you maybe I will try cutting it in to 3 pieces.


My boy is also having liquid poops, but he's also constipated all in a day. I'm also having a hard time getting blood from my boy. You may have to start over. Warm ear Vaseline & poke that's been working for me so far.
 
Tami & Bear said:
The blood doesn't bubble when I stick him, it just seeps out into the fur and I can't pull it onto the strip. This is his normal feeding and injection time.
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Vaseline on ear before you test will help to bead the blood drop. And if you can't see the blood drop easily, a good pair of prescription glasses, and a little extra light works wonders. I bought a headlamp many years ago and it was the best $15 I ever spent. When I first began, I thought I wasn't getting any blood, then I realized I just couldn't see it.
 
Thanks for that, I'll give it a try. Today was so stressful for us both that I gave it a rest for the evening. I decided to puree some gastrointestinal food mixed with water and fed him that without incident. Between that and the food he got earlier I felt comfortable giving him his insulin, as both foods were higher in carbs than what he's been getting. He perked up a bit after dinner, drank some water on his own and is resting now, so we'll see what the vet has to say in the morning. I really appreciate you taking the time to chat with me <3
 
You are very welcome, sending positive thoughts, hope Bear continues to perk up this evening, and keeps eating. Good luck at the vet tomorrow.
 
Just an update: We avoided hospitalization today. Bear was sent home with gastrointestinal food for me to puree, more gabapentin, anti nausea meds, and IV fluids that I'll be administering.
 
Glad you guys are home, I was thinking about asking for an update, then I got dragged into a work call :rolleyes:. What did your vet think was going on with Bear? Did they run any labs or urinalysis, or did you finally get the blood tests from the emerg vet yet? The gastro food will likely influence his BG numbers, but in the short term, it's better he eats something consistently. I didn't mention it yesterday, since you had a lot going on, but it might be worth checking for ketones if you aren't already. You can pick up Ketostix from any pharmacy and test his irons, following the instructions on the box.

The basic recipe for developing DKA is an insufficient supply of insulin + inappetance + infection or other systemic stresses

Keep us posted, hope Bear feels better soon.
 
They agreed it's pancreatitis based on his symptoms, the bloodwork from the ER vet, and discomfort at pushing the area (sorry, should have lead with the lead!). They said it was mild enough to do outpatient, and trusted me to give it a try vs. having to drag him back in daily. They checked for keytones and didn't find any. Sugar wasn't the *worst* - 366 pre insulin or food + severe vet stress. He's going to hang out at home at least through the weekend barring any emergencies and we'll check in with the vet on Monday.

He's sleeping in a fairly relaxed looking state next to the open window as I write, so hopefully he will heal up!
 
If you find he doesn't like the gastro food, perhaps go back and ask for some cans of the Hills A/D recovery food. Most cats seem to like the taste and it's nice and smooth so makes an easy purée especially if you need to syringe feed. Good too that you can give subq fluids at home, that should help him feel better.
 
The dose of gabapentin depends a lot on the cats. My Moxie too 5bg twice daily for years for join degradation and it worked fine with no abnormal/sedation noted.
I gave my Mia 100mg before vet visits and it did not do much.
I give my Nala 100mg before vet visits and it sedates well.
I give my Snuffles 150mg (split in time) before vet visits and I wish it did more.
 
Thanks again for the help here :) We were able to completely stop syringe feedings by dinner yesterday. It's taking a lot of reminders and pushing food around on the plate to get Bear to eat full meals, but he's doing it. We're going to continue subq fluids for the next few days and BG has been fairly consistent, with mid-to-high 200's before injection/food.

I called the ReliOn customer service line and figured out what I was doing wrong with the meter, so hopefully I can start charting a more reliable curve. FYI in case anyone else has my issue - I was getting an E-0 error. I was pulling the meter away from Bear's ear once the strip was full because I didn't want to keep pestering him with it, but I needed to keep holding it on the blood bubble until it beeped (even though the strip was full).
 
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