? 5/3 Binie, high fever, loss of appetite, how to handle Insulin with less food?

[Heike & BInie]

Last post: https://www.felinediabetes.com/FDMB/threads/5-1-binie-amps-389-3-306-new-dose-and-good-news.289479/

Good evening,

unfortunately things got more complicated. Binie is feeling quite sick and I would like to ask for advice I hopefully don't need. Yesterday I went to the vet because Binie was still not well again and I suspected she had temperature. She does not let me take her temperature so it is always a bit of guessing. Besides her ketones rose up. Before I never saw more than 0,3 mg/dl, yesterday it was 0,5 mg/dl which started to worry me.

The vet said the wound looks fine but maybe there is a little bit of inflamation left. Binie had moderate temperature yesterday but she was still eating fine. So she prescribed antibiotics (Efex) and more pain meds (Onsior). She also removed the stiches. When we went home I felt that Binie reacted immediately to the medication and the evening was quite relaxed.

At night I woke up and I could feelt that Binies ears are very hot again. Besides she didn't touch her food. In the morning I had problems to get something into her to give her the shot. The ketones rised to 0,6 mg/dl. So I called the vet and she asked us to come again. When she took the temperature it was really high (39,9 C/103,82 F). She was confused as the wound looks really good and is not sensitive to touch.

She worries, Binie developed something else like pancreatitis or a beginning DKA. She gave subcutaneous fluids and an Novalgin injection. I should skip the Onsior as it would not go along with pancreatitis. We didn't take blood as that would stress Binie and wouldn't change the treatment. I asked what to do if Binie is not eating enough or nothing at all. She said I shouldn't skip the injection or reduce it too much because of the ketones. If she is eating very few or not at all I could reduce but I should not go lower than 2 IU.

Thank god I could get quite some food in her today. And her ketones decreased from 0,6 this morning to 0,2 at +11. She did not eat at shot time now but I hope to get something into her later and gave the whole 2,75 IU. She is still very calm but her ears don't feel that hot anymore. Taking temperature still doesn't work even though I bought a fancy infrared thermometer to measure in the ear.

But what do I do if she should stop eating at all and I can't get food into her? I feel 2 IU with no food is too dangerous. I never force feeded her before. I took a feeding-syringe from the vet but I am not sure if she will let me do it. Is the vet right with 2IU or should I reduce more or go right away in an emergency clinic?

I really hope I mangage to get some more food inside her later to not run into problems tonight. This is so stressful. As I don't own a car I rented one for the weekend and will pick it up now to be prepared, if we have to go to the clinic. Hopefully the only use of the car will be to do my groceries tomorrow.....

Hope everyone is having a relaxed weekend!

 

[Staci & Ivy]

Last post: https://www.felinediabetes.com/FDMB/threads/5-1-binie-amps-389-3-306-new-dose-and-good-news.289479/

Good evening,

unfortunately things got more complicated. Binie is feeling quite sick and I would like to ask for advice I hopefully don't need. Yesterday I went to the vet because Binie was still not well again and I suspected she had temperature. She does not let me take her temperature so it is always a bit of guessing. Besides her ketones rose up. Before I never saw more than 0,3 mg/dl, yesterday it was 0,5 mg/dl which started to worry me.

The vet said the wound looks fine but maybe there is a little bit of inflamation left. Binie had moderate temperature yesterday but she was still eating fine. So she prescribed antibiotics (Efex) and more pain meds (Onsior). She also removed the stiches. When we went home I felt that Binie reacted immediately to the medication and the evening was quite relaxed.

At night I woke up and I could feelt that Binies ears are very hot again. Besides she didn't touch her food. In the morning I had problems to get something into her to give her the shot. The ketones rised to 0,6 mg/dl. So I called the vet and she asked us to come again. When she took the temperature it was really high (39,9 C/103,82 F). She was confused as the wound looks really good and is not sensitive to touch.

She worries, Binie developed something else like pancreatitis or a beginning DKA. She gave subcutaneous fluids and an Novalgin injection. I should skip the Onsior as it would not go along with pancreatitis. We didn't take blood as that would stress Binie and wouldn't change the treatment. I asked what to do if Binie is not eating enough or nothing at all. She said I shouldn't skip the injection or reduce it too much because of the ketones. If she is eating very few or not at all I could reduce but I should not go lower than 2 IU.

Thank god I could get quite some food in her today. And her ketones decreased from 0,6 this morning to 0,2 at +11. She did not eat at shot time now but I hope to get something into her later and gave the whole 2,75 IU. She is still very calm but her ears don't feel that hot anymore. Taking temperature still doesn't work even though I bought a fancy infrared thermometer to measure in the ear.

But what do I do if she should stop eating at all and I can't get food into her? I feel 2 IU with no food is too dangerous. I never force feeded her before. I took a feeding-syringe from the vet but I am not sure if she will let me do it. Is the vet right with 2IU or should I reduce more or go right away in an emergency clinic?

I really hope I mangage to get some more food inside her later to not run into problems tonight. This is so stressful. As I don't own a car I rented one for the weekend and will pick it up now to be prepared, if we have to go to the clinic. Hopefully the only use of the car will be to do my groceries tomorrow.....

Hope everyone is having a relaxed weekend!

Hi Heike, I’m so sorry to hear, but Binie is not feeling well or eating very well.
You must be so worried. It’s the worst thing when they won’t eat. I’ve had to syringe feed Ivy multiple times after sedations to get her eating again. I know there’s lots of suggestions here of how to get a kitty to eat.
https://www.felinediabetes.com/FDMB/threads/suggestions-on-how-to-stimulate-kittys-appetite.130770/
(Maybe you could take her food and blend it in the processor with a little water to make it into a form of liquid instead of perhaps chunky food. Also, sometimes Ivy eats from a spoon for me in small amounts if she’s not feeling well.)

I know what I’ve done is take Ivy‘s food, which is very liquidy, and very slowly, very gently just in small amounts syringe into her mouth into (the side never into the back because you don’t want them to choke or aspirate).
Sending prayers and lots of good wishes that she will start to eat again very soon.
Please keep us posted. Sending you warm and gentle hugs of support.

 

[Heike & BInie]

Thank you for you warm support and all the information Staci! I read the suggestions and I really hope I get something inside her later. I was in so much conflict tonight if I should give the full dose or not. I gave her novalgin one hour ago and I hope it helps her to feel better and than maybe the appetite comes back. I will not harrass her with food for another hour and than I will try again with some of the ideas in the link. If all this is not working I prepare myself to syringe feed. I feel there is another sleepless night coming. I really hope we don't have to go into the clinic, which is more than one hour drive. Hope you can a little relax at the weekend and have faith, that everything goes well an monday.

 

[Chris & China (GA)]

But what do I do if she should stop eating at all and I can't get food into her? I feel 2 IU with no food is too dangerous.

Hopefully you'll get more eyes on your post soon, but in my opinion, I would go ahead and give the 2U, whether she eats or not. Her BG is more than high enough and with ketones in the picture, she must get her insulin.

Also, when ketones are in the picture, you may need to try something higher carb and see if she'll eat.

1. she must get insulin
2. she needs to eat, even if it's higher in carbs or you have to syringe feed
3. keep a close eye on those ketones (which I know you are)

 

[Wendy&Neko]

Do you have any anti nausea medications at home, like ondansetron or Cerenia (maropitant)? If it is pancreatitis, they need anti nausea meds too.

Did she get insulin this morning? Spreadsheet is blank for units. She does need insulin to combat ketones/possible DKA.

In addition to Chris's list above, she needs plenty of fluids to flush out the ketones. Water down any food you are syringe feeding her. Maybe make her something tasty like chicken broth which is made from just boiling chicken - no spices.

When Neko was off her food, I was OK giving full dose of insulin if she got at least 2/3 of her required calories. Note, you can up the calories with a food with higher fat content, like kitten food.

 

[Heike & BInie]

Hopefully you'll get more eyes on your post soon, but in my opinion, I would go ahead and give the 2U, whether she eats or not. Her BG is more than high enough and with ketones in the picture, she must get her insulin.

Also, when ketones are in the picture, you may need to try something higher carb and see if she'll eat.

1. she must get insulin
2. she needs to eat, even if it's higher in carbs or you have to syringe feed
3. keep a close eye on those ketones (which I know you are)

Thank you so much Chris! Yes, maybe I have to try higher carbs. I am still waiting she may gets appetite on her own but if she does not eat in an hour (+4), I have to do something. If you say I should keep an eye one the ketones: How often should I test? The vet said twice a day and I thought about doing it before the shots or should I test more often?

 

[Heike & BInie]

Do you have any anti nausea medications at home, like ondansetron or Cerenia (maropitant)? If it is pancreatitis, they need anti nausea meds too.

Did she get insulin this morning? Spreadsheet is blank for units. She does need insulin to combat ketones/possible DKA.

In addition to Chris's list above, she needs plenty of fluids to flush out the ketones. Water down any food you are syringe feeding her. Maybe make her something tasty like chicken broth which is made from just boiling chicken - no spices.

When Neko was off her food, I was OK giving full dose of insulin if she got at least 2/3 of her required calories. Note, you can up the calories with a food with higher fat content, like kitten food.

Thank you so much Wendy! Yes, she got 2,75 IU insuline in the morning and in the evening. I just forgot to put it in the sheet because I am so out of my head. Chicken is a good idea, I will buy it tomorrow. She used to drink a lot but with the low appetite she also stopped drinking so much. I have a kind of cat drink she gets as a treat during testing or injection, I thought about watering that down to make her drink more. This is also my option to feed that if she doesn't start eating soon.

I asked about the nausea medication at the vet and she gave something as in injection with a duration of 24 hours but I forgot to ask which one. Somehow her symptoms don't quite fit a pancreatitis. She didn't vomit and she has no diarrhea. She even had to get an enema at the vet yesterday because she was constipated.

 

[Chris & China (GA)]

How often should I test? The vet said twice a day and I thought about doing it before the shots or should I test more often?

Twice a day is reasonable. Maybe if one test is higher than the last, test again the next time she pees (if she pees before the 2nd test) to see if they're still going up, staying stable or dropping.

 

[Heike & BInie]

Twice a day is reasonable. Maybe if one test is higher than the last, test again the next time she pees (if she pees before the 2nd test) to see if they're still going up, staying stable or dropping.

That make sense! I test the ketones in the blood, not the urine. So it is even easier because I can test whenever I want (or whenever she lets me...). And thank you for pointing out that higher carb food is o.k. in that situation. I just gave her the royal canin kibble she got from the vet for her digestion before the fd-diagnosis and she ate not much but quite a reasonable amount. Thank you!

 

[Wendy&Neko]

nausea medication at the vet and she gave something as in injection with a duration of 24 hours

That would be Cerenia. Not as good as ondansetron in my experience but will be some help.

Pancreatitis doesn't always present with GI symptoms: A Primer On Pancreatitis

 

[Heike & BInie]

That would be Cerenia. Not as good as ondansetron in my experience but will be some help.

Pancreatitis doesn't always present with GI symptoms: A Primer On Pancreatitis

Oh wow, what a valuable ressource of information. Thank you Wendy! I just watched the clip about syringe feeding and it helped to be prepared.

 

[Diane Tyler's Mom GA]

Hi Heike, I'm so sorry Binie isn't feeling well poor baby .
Sending prayers she will start to eat on her own .

 

[tiffmaxee]

Max had chronic pancreatitis for several years and I think he only had gi issues once during a bout. I git medication to have on hand because it was a holiday weekend but never used it. He never had a fever either. I hope Binie feels better real soon.

 

[Heike & BInie]

Hi Heike, I'm so sorry Binie isn't feeling well poor baby .
Sending prayers she will start to eat on her own .

Thank you Diane! I will give an update in a new thread! Hope you have a nice saturday!

 

[Heike & BInie]

Max had chronic pancreatitis for several years and I think he only had gi issues once during a bout. I git medication to have on hand because it was a holiday weekend but never used it. He never had a fever either. I hope Binie feels better real soon.

Thank you for sharing that! Pancreatitis is new for me but we will find out next week if that is what she is suffering from. On tuesday we wanted to do a bloodwork anyway.