Vomited and not very hungry

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JMaw

JMaw

Member Since 2023
Hi!
My Bubby threw up his dinner from last night early this morning. All of it, by the looks of it. He only ate a couple of bites of his breakfast (I feed him tiki and ff chicken classics). He took maybe 3 bites of the ff and ate no tiki. I did not give his shot. His BG before eating was 368. I don't test before every meal every day but do periodic curves. His BG is generally in the mid-300s and sometimes goes into the 200s mostly in the morning. He is on 2.5 units of glargine. I was planning to talk to his vet tomorrow before this happened about his dosage.

Today he is not very hungry but is very thirsty. He sat in front of the water bowl for a bit and is drinking a lot. It looks like he has been peeing a lot as well over the past two days. I ran out and bought keto strips this morning hoping to catch him next time he goes pee. He feels off for sure but jumped on the table to sniff something earlier so he isn't so sick he isn't curious anymore.

My question is if I should keep offering him food throughout the day or stick to his feeding schedule.

Also, I will take any insights so long as nobody gets all alarmist on me. I plan to monitor him closely and will take him to the emergency vet if it becomes clear that he needs it.

Thank you :)
 
I’d keep offering food yes. Do you have any anti-nausea anti vomiting meds like Cerenia or Ondansetron? I feel like these are a must for those of us with diabetic cats since getting them to eat is always a priority. Have you tried any other enticing foods like tuna or baby food? You really want to test his bg before each shot but more importantly so today since he’s not eating and you need to make sure his preshot numbers are safe to give the regular insulin dose. Testing only sporadically does not give you the accurate picture of whether or not he’s regulated and it also doesn’t give you any data when it comes to dose adjustments. Would you be willing to start testing at least at preshots every day?
 
It's possible that there's a GI bug that has effected your cat. All you can do is see if the upset stomach persists. Just like with humans, sometimes there's a GI bug that goes around and kitties vomit or have diarrhea. I would not suggest letting your cat go for more than a day or two without eating.

I'm going to be a bit presumptive so apologies first. Is there any reason you want have Bubby in higher numbers. His numbers are above renal threshold. Diabetes is hard on the kidneys to begin with and having him in numbers above the lower 200s is especially hard on his kidneys. We do have information available about dosing glargine if you are interested. I'd also encourage you to always test before giving a shot. If you are shooting blind, you could inadvertently give your cat a dose of insulin when his numbers were quite low. Blood glucose levels can change unpredictably.
 
Ale & Bobo & Minnie (GA) said:
I’d keep offering food yes. Do you have any anti-nausea anti vomiting meds like Cerenia or Ondansetron? I feel like these are a must for those of us with diabetic cats since getting them to eat is always a priority. Have you tried any other enticing foods like tuna or baby food? You really want to test his bg before each shot but more importantly so today since he’s not eating and you need to make sure his preshot numbers are safe to give the regular insulin dose. Testing only sporadically does not give you the accurate picture of whether or not he’s regulated and it also doesn’t give you any data when it comes to dose adjustments. Would you be willing to start testing at least at preshots every day?
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I put out tuna juice at 12ish and he vomited after smelling it. Then he ate the juice, some tuna, and a ton more water.

They can take ondansetron? I have some for myself. What dosage?
 
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Sienne and Gabby (GA) said:
It's possible that there's a GI bug that has effected your cat. All you can do is see if the upset stomach persists. Just like with humans, sometimes there's a GI bug that goes around and kitties vomit or have diarrhea. I would not suggest letting your cat go for more than a day or two without eating.

I'm going to be a bit presumptive so apologies first. Is there any reason you want have Bubby in higher numbers. His numbers are above renal threshold. Diabetes is hard on the kidneys to begin with and having him in numbers above the lower 200s is especially hard on his kidneys. We do have information available about dosing glargine if you are interested. I'd also encourage you to always test before giving a shot. If you are shooting blind, you could inadvertently give your cat a dose of insulin when his numbers were quite low. Blood glucose levels can change unpredictably.
Click to expand...

I don't want to have him at higher numbers??? He was only diagnosed at the end of November and started insulin Dec 1st. We started at 1unit and worked up to 2.5units, which takes time. As I said, I was planning to discuss the consistently elevated numbers with his vet tomorrow. I test him quite a bit and he has had 2 Libres on since the beginning of Dec.

Back to the issue at hand...
I put out tuna juice at 12ish and he vomited after smelling it. Then he ate the juice, some tuna, and a ton more water.

Would he be drinking so excessively if it were a bug (vs something diabetes related)?
 
JMaw said:
I put out tuna juice at 12ish and he vomited after smelling it. Then he ate the juice, some tuna, and a ton more water.

They can take ondansetron? I have some for myself. What dosage?
Click to expand...
It depends on the weight. What’s his weight? Bobo is 15 pounds and he started on 1/2 a 4mg pill x2 a day. He’s now at 1 4mg pill x2 a day
 
JMaw said:
I don't want to have him at higher numbers??? He was only diagnosed at the end of November and started insulin Dec 1st. We started at 1unit and worked up to 2.5units, which takes time. As I said, I was planning to discuss the consistently elevated numbers with his vet tomorrow. I test him quite a bit and he has had 2 Libres on since the beginning of Dec.

Back to the issue at hand...
I put out tuna juice at 12ish and he vomited after smelling it. Then he ate the juice, some tuna, and a ton more water.

Would he be drinking so excessively if it were a bug (vs something diabetes related)?
Click to expand...
If you can setup your spreadsheet and plug some of the numbers from the libre, it would be helpful. It’s hard to get a cat regulated with vet guidance alone since most vets don’t advocate for home testing and know little about nutrition and how it relates to feline diabetes. For instance, you want to feed a diabetic only low carb foods and vets will often suggest prescription foods which are mostly higher carb foods. I would ask for a prescription to Cerenia as well since Cerenia and ondansetron can be give in conjunction and work differently.

we recommend an average of 4 tests a day, but of course if you have the libre you’ll be getting consistam readings throughout the day
 
Ale & Bobo & Minnie (GA) said:
If you can setup your spreadsheet and plug some of the numbers from the libre, it would be helpful. It’s hard to get a cat regulated with vet guidance alone since most vets don’t advocate for home testing and know little about nutrition and how it relates to feline diabetes. For instance, you want to feed a diabetic only low carb foods and vets will often suggest prescription foods which are mostly higher carb foods. I would ask for a prescription to Cerenia as well since Cerenia and ondansetron can be give in conjunction and work differently.

we recommend an average of 4 tests a day, but of course if you have the libre you’ll be getting consistam readings throughout the day
Click to expand...

The emergency vet (I called) said not to give an antiemetic since it could mask symptoms. They suggested I bring him in bc I did a ketone strip and it was high (80).
 
Would you guys bring him to the emergency vet today or wait until his vet is open in the morning???
 
Ketones happen when the cat is not getting enough insulin and enough food. I don’t know that I agree with the er vet about masking the symptoms. He needs to eat so make sure at the er to ask what they’re going to be doing in order to feed him and make sure he gets enough food. Any food he’ll eat right now, low carb or not.
 
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Sienne and Gabby (GA) said:
Please get your cat to the vet. High ketones are an emergency situation.
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His ketones are .9 and BG 416. He is very dehydrated. They want to keep him overnight to give fluids and run a million tests for $4000.

Is it bad if I just have them do fluids and anti nausea meds and then take him to my vet tomorrow for any tests? I can't afford $4000!!!!
 
I don’t know that a regular vet can treat the ketones @Sienne and Gabby (GA) will this lead to DKA?

what did you decide?

from what I understand, untreated ketones can lead to DKA. The basics for DKA are that there is an infection or inflammation present + not enough calories + not enough insulin. Typically, a cat is on IV fluids to correct for dehydration and is usually supplemented with dextrose which provides some nutrition. The IV should also be supplemented with electrolytes. The vet should be getting blood tests at least twice a day to check on potassium, sodium, and phosphorus levels as well as other levels. Insulin should not be stopped. Often the vets will use a short acting insulin (e.g., "regular" insulin -- Novolin R or Humulin R) as a bolus and ultimately along with a longer acting insulin such as Lantus. It's also important to get your cat to eat. Cats usually feel pretty lousy with DKA so appetite stimulants and anti-nausea medication may be used. In all likelihood, your cat may also need an antibiotic.

This is an older paper that provides some good information on treating DKA so you have a good idea about what should be done. Treating DKA is expensive. It's a life threatening condition and it requires constant monitoring and frequent lab tests.
 
Ale & Bobo & Minnie (GA) said:
I don’t know that a regular vet can treat the ketones @Sienne and Gabby (GA) will this lead to DKA?

what did you decide?

from what I understand, untreated ketones can lead to DKA. The basics for DKA are that there is an infection or inflammation present + not enough calories + not enough insulin. Typically, a cat is on IV fluids to correct for dehydration and is usually supplemented with dextrose which provides some nutrition. The IV should also be supplemented with electrolytes. The vet should be getting blood tests at least twice a day to check on potassium, sodium, and phosphorus levels as well as other levels. Insulin should not be stopped. Often the vets will use a short acting insulin (e.g., "regular" insulin -- Novolin R or Humulin R) as a bolus and ultimately along with a longer acting insulin such as Lantus. It's also important to get your cat to eat. Cats usually feel pretty lousy with DKA so appetite stimulants and anti-nausea medication may be used. In all likelihood, your cat may also need an antibiotic.

This is an older paper that provides some good information on treating DKA so you have a good idea about what should be done. Treating DKA is expensive. It's a life threatening condition and it requires constant monitoring and frequent lab tests.
Click to expand...

Hi. I left him at er overnight for fluids electrolytes nausea meds etc.
They gave him vetsulin lastnight and his BG went down to 120. That is the first time it has really been below the 300s. But just now he looked terrible so we ran it again and it was 44. They gave dextrose.
I am at regular vet now running all suggested tests. They will keep him on iv fluids etc while here. If he doesn't improve or if we discover some underlying thing he may go back to er for the night. We have no idea why his BG is all over the map. They suspect something sinister like a pancreatic tumor.
 
I would not worry about a pancreatic tumour at this point. In my experience here it is much more likely to be DKA or pancreatitis or another infection.
Are they checking for an infection or inflammation? It is important they do. Please check with the vet about this. Get them to check for a UTI and pancreatitis ( fPL test) it is not in the regular blood tests.
It is not enough insulin, not enough calories and an infection or inflammation that can lead to DKA after ketones form.
Are the vets checking the electrolytes?

Once you get Bubby home we can help you with what you. Make sure you have Ketostix and plenty of food at home. And please set up the spreadsheet. If you need help with it we can assist you
 
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