1/26/20 NEW MEMBER- im lost and scared

[Sarah97]

Hello, my name is Sarah. I adopted Tiggo 2 weeks ago.He's a male mixed long hair breed. Castrated mid december. When he first came he had diarrhea and he was always hungry, drinking more than 400 ml water and peeing way too much that i went through 50lbs of litter in these two weeks. So i talked to his foster parents and they informed me that his diarrhea wasn't new and he already took an intestinal parasite injection. Later on i took him to the vet and he took a probiotic shot. a week later he took a deworming pill and the day he took it i saw long thing worms( my guess is its roundworms) in his stool. So the vet prescribed Metronidazole. Mind you-the two vets he saw said that he's drinking a lot due to his diarrhea. He took the medicine for 7 days with no signs of improvement until Saturday. I woke up and my usual hungry baby that begged for food had no energy and refused to eat. I decided to see another vet. After running some general blood tests, biochemisty test and urine test he found out the following:
-Extreme high sugar levels in urine
-High ketones in urine
-Blood in Urine
- Low platelets count (68000/ml - normal range is between 300000 and 800000)---He said it was okay ??!!!
-Blood Glucose was 26.69mmol/L ( HIGH)
-GLOB was 60 g/L (HIGH)
-ALKP 11 U/L (LOW).
-T4 test was negative

So he decided Tiggo should stay for 3 days in the hospital on IV fluids. and two additional days for the fructosamine test. I called today to check up on him, the vet said he still wasn't eating but it is okay.???(HOW)

I'm lost and heartbroken. I lost my two year old baby in october 2019 suddenly and i wanted to give another cat a chance and this happens I live in Lebanon so we do not have a wide access of food types and vets as good as that in the US. a small can of wet food is around 2$ here.

I HAVE SO MANY QUESTIONS I'M OVERWHELMED.

 

[Ann & Scatcats]

He is clearly diabetic and with ketones in urine probably in DKA, diabetes keto acidosis. The latter is something only an Intensive Care Er can regulate.

Apart from that there should be high protein, moderate fat and low carbohydrates food in Lebanon.

 

[Sam & Esse]

Hello Sarah

I am sorry to hear Tiggo is doing so poorly

With high ketones in the urine it is likely that Tiggo has Diabetic Ketoacidosis, or DKA. If this is the case, then the hospital is the best place for Tiggo to be right now. You can read more about DKA here:
Ketones, Diabetic Ketoacidosis (DKA), and Blood Ketone Meters
The basic recipe for developing DKA = an insufficient supply of insulin + inappetance + infection OR other systemic stresses. If Tiggo has been diabetic for a while, plus the stress of having worms and multiple vet visits, it could very well have pushed him into DKA. While DKA is a very serious condition, cats can and do make full recoveries from it, and a veterinary hospital is the very best place for treatment for DKA.

That Tiggo is still not eating is not as good. Would the doctor allow you to come visit Tiggo, and try to feed him yourself? This sometimes helps to get cats eating.

While Tiggo is in hospital, you can help by learning about feline diabetes beforehand It seems overwhelming at first, but take deep breathes, and breaks if you're trying to learn too much information at once.

New? Seeing Low Numbers? How You Can Help Us Help You
This link will help you understand the very basics of getting started with insulin, and using this message board. It contains information and links on setting up a signature, and a spread sheet for future use. Important information for you to include in your signature right now is that Tiggo has not yet started insulin at home, is in hospital with high ketones/possible DKA, recently has/had worms, and that your location is Lebanon.

You have done a wonderful thing adopting Tiggo. Do call the vet and see if they will allow you to visit; Tiggo will see that you love him very much

Edited to add: A common reason for low platelets to show on a blood test is because they clumped together before the blood test could be ran. So they read at the very bottom of the range, but the lab will usually make a comment about platelet clumping. This may be what happened, and why the doctor said it was okay.

 

[Nan & Amber (GA)]

Oh, my. I am so sorry you and Tiggo are going through this!

I agree about the diabetes and ketones. The ketones in particular can progress quickly to potentially life-threatening ketoacidosis (if they haven't already), and I'm concerned that your vet is not concerned that Tiggo is not eating. In those circumstances, he needs both food and insulin, as well as close monitoring of blood biochemistry and other health indicators.

It also sounds like there are some other health challenges going on. I hope that just reducing the parasite load and the hit of antibiotics will clear up the anemia and blood in the urine and get him feeling better. Did the vets try culturing for bacteria in the urine? Sometimes, if they know the specific target, then they can hit it with the most effective antibiotic.

 

[Bron and Sheba (GA)]

Hello Sarah and Tiggy and welcome.
I am so sorry Tiggy is unwell. Not checking his blood sugar earlier, was really remiss of the vet.

Is the vet giving Tiggo an antinausea medication? Cats who have ketones or DKA are almost always nauseated and will require antinausea medication to help them to eat. Please ask them to give him some cerenia or ondansetron.
You will need to make sure they give you some cerenia or ondansetron tablets to bring home with you as well.....this is very important.

Once you get him home you will need to make sure he is eating plenty of food as food is like a medicine with ketones or DKA.
At the moment anything he will eat is OK.

Also he will need to get his doses of insulin as this is also very important in the recovery of ketones or DKA.
I would recommend you go out and buy a human glucose meter from a chemist and learn to test the blood glucose levels as this will keep Tiggo safe. We can teach you how to do it. It is not hard.

Also while at the chemist/pharmacy buy a bottle of Ketostix which will let you test the urime for ketones each day. It is a simple urine test which we can explain closer to when he comes home.

I know this is a lot for you to take in at the moment but you have come to the very best place for help and we will help you every step of the way.

For now, if you can read the link below and if needed someone can help you get the spreadsheet set up. It is a lot in the beginning for you to get your head around but it does get easier and we are here for you.

So things to do now are

• Ask the vet about antinausea medication for Tiggo.
• Let him ate anything he will eat..he must eat.ask if you can take in food for him. What they are offering may not be appetising.
• Ask the vet what type of insulin he is giving and what he will come home on
• Go to the pharmacy and buy the human glucose meter and the Ketostix
• Read the link below
• Get in some foods he will eat. Low carb food is best for diabetic cats but the most important thing at the moment is he eats.
• Keep asking us questions and keep posting with updates.

http://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

Sending very best wishes to Tiggo and a to you
Bron

 

[Ann & Scatcats]

Hi Sarah, out of curiosity, were in Lebanon are you?
My brother was stationed in Naquora with the UN Armed Forces in the beginnings of the 1990, and I know there is still a lot of problems going on in entire Lebanon.
Do they really have good veterinarians there?

What is that veterinarian of yours doing to treat your Tiggo?
You are an Angel to Tiggo for adopted him and I just hope he gets the right and best care by the veterinarian.

 

[Sarah97]

Hello I’m in Beirut, the capital. A lot has changed since then. Yes there are still many problems that arise every now and then but we’re still good. Probably the worst thing that happened in the past months is the drastic increase in prices including pet care . His vet studies in France and the USA so he’s considered one of the best vets here. But with experience comes the high vet bills ..
I won’t lie I was close to backing out and retiring him to his foster house but I know they won’t be able to keep up with him.

Hi Sarah, out of curiosity, were in Lebanon are you?
My brother was stationed in Naquora with the UN Armed Forces in the beginnings of the 1990, and I know there is still a lot of problems going on in entire Lebanon.
Do they really have good veterinarians there?

What is that veterinarian of yours doing to treat your Tiggo?
You are an Angel to Tiggo for adopted him and I just hope he gets the right and best care by the veterinarian.

 

[Sarah97]

Hello Sarah and Tiggy and welcome.
I am so sorry Tiggy is unwell. Not checking his blood sugar earlier, was really remiss of the vet.

Is the vet giving Tiggo an antinausea medication? Cats who have ketones or DKA are almost always nauseated and will require antinausea medication to help them to eat. Please ask them to give him some cerenia or ondansetron.
You will need to make sure they give you some cerenia or ondansetron tablets to bring home with you as well.....this is very important.

Once you get him home you will need to make sure he is eating plenty of food as food is like a medicine with ketones or DKA.
At the moment anything he will eat is OK.

Also he will need to get his doses of insulin as this is also very important in the recovery of ketones or DKA.
I would recommend you go out and buy a human glucose meter from a chemist and learn to test the blood glucose levels as this will keep Tiggo safe. We can teach you how to do it. It is not hard.

Also while at the chemist/pharmacy buy a bottle of Ketostix which will let you test the urime for ketones each day. It is a simple urine test which we can explain closer to when he comes home.

I know this is a lot for you to take in at the moment but you have come to the very best place for help and we will help you every step of the way.

For now, if you can read the link below and if needed someone can help you get the spreadsheet set up. It is a lot in the beginning for you to get your head around but it does get easier and we are here for you.

So things to do now are

• Ask the vet about antinausea medication for Tiggo.
• Let him ate anything he will eat..he must eat.ask if you can take in food for him. What they are offering may not be appetising.
• Ask the vet what type of insulin he is giving and what he will come home on
• Go to the pharmacy and buy the human glucose meter and the Ketostix
• Read the link below
• Get in some foods he will eat. Low carb food is best for diabetic cats but the most important thing at the moment is he eats.
• Keep asking us questions and keep posting with updates.

http://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

Sending very best wishes to Tiggo and a to you
Bron

So he’s not eating due to nausea ? The vet never mentioned it. Although he did say he’ll give him vitamins to increase his appetite as well as proplan fortiflora probiotic. I don’t know how the vet will feel if I go in with FF pate and ask him to feed him these. I think we all agree that Vets go crazy for Royal Canin and Hill’s.
what will happen if I get him Home and he still doesn’t eat? my dad has a serious heart surgery tomorrow and I’m trying to balance Work, dad and Tiggo . This is making my anxiety 100 times worse. I’m afraid he will have a hypo episode the first few days.

 

[Sarah97]

T

Oh, my. I am so sorry you and Tiggo are going through this!

I agree about the diabetes and ketones. The ketones in particular can progress quickly to potentially life-threatening ketoacidosis (if they haven't already), and I'm concerned that your vet is not concerned that Tiggo is not eating. In those circumstances, he needs both food and insulin, as well as close monitoring of blood biochemistry and other health indicators.

It also sounds like there are some other health challenges going on. I hope that just reducing the parasite load and the hit of antibiotics will clear up the anemia and blood in the urine and get him feeling better. Did the vets try culturing for bacteria in the urine? Sometimes, if they know the specific target, then they can hit it with the most effective antibiotic.

The vet never mentioned culturing bacteria. Although he did a urine culture so shouldn’t that be apparent ? I will ask him to syringe feed him if he’s not eating. How will he able to do fructosamine test if he is not eating ?

 

[Ann & Scatcats]

So he’s not eating due to nausea ? The vet never mentioned it. Although he did say he’ll give him vitamins to increase his appetite as well as proplan fortiflora probiotic. I don’t know how the vet will feel if I go in with FF pate and ask him to feed him these. I think we all agree that Vets go crazy for Royal Canin and Hill’s.
what will happen if I get him Home and he still doesn’t eat? my dad has a serious heart surgery tomorrow and I’m trying to balance Work, dad and Tiggo . This is making my anxiety 100 times worse. I’m afraid he will have a hypo episode the first few days.

How high dose of insulin is Tiggo getting morning and evening?
What type of insulin is he given?
With careful management with the insulin the risks of hypo are reduced.

What plan does your vet have for you and Tiggo in the diabetes management when Tiggo is home?

So sorry to hear about your father having a critical surgery, but please do try and breath and I hope for a good outcome for all three of you, yourself, your dad and Tiggo.

 

[Bron and Sheba (GA)]

So he’s not eating due to nausea ? The vet never mentioned it. Although he did say he’ll give him vitamins to increase his appetite as well as proplan fortiflora probiotic. I don’t know how the vet will feel if I go in with FF pate and ask him to feed him these. I think we all agree that Vets go crazy for Royal Canin and Hill’s.
what will happen if I get him Home and he still doesn’t eat? my dad has a serious heart surgery tomorrow and I’m trying to balance Work, dad and Tiggo . This is making my anxiety 100 times worse. I’m afraid he will have a hypo episode the first few days.

Yes I would think he's not eating due to nausea. Please ask them to consider giving him a cerenia injection for the nausea.
Just turn up with the FF and sayi want to try m with that. He's your cat!
A lot of cats arrive home not eating much. You will need to get some antinausea medication that I mentioned above from the vet before he leaves hospital and you may need to syringe feed. They may consider putting a tube in until his appetite returns.
It is VERY common for cats with ketones and DKA to have no appetite for a while but it does eventually return.

T

The vet never mentioned culturing bacteria. Although he did a urine culture so shouldn’t that be apparent ? I will ask him to syringe feed him if he’s not eating. How will he able to do fructosamine test if he is not eating ?

If he did a urine culture that should show any infection.
They can do a Fructosamine test without eating. It is a blood test.

Best wishes to your father for his surgery.
You have a lot on your plate at the moment.

 

[Sarah97]

How high dose of insulin is Tiggo getting morning and evening?
What type of insulin is he given?
With careful management with the insulin the risks of hypo are reduced.

What plan does your vet have for you and Tiggo in the diabetes management when Tiggo is home?

So sorry to hear about your father having a critical surgery, but please do try and breath and I hope for a good outcome for all three of you, yourself, your dad and Tiggo.

We still do not have a plan for him yet. Once he’s done with the fructosamine tes, I’ll sit down with the vet and talk about everything. I already prepared my questions. I’m trying my best. I got so attached to him and I really want to save his life. He deserves the best.

 

[Sarah97]

Yes I would think he's not eating due to nausea. Please ask them to consider giving him a cerenia injection for the nausea.
Just turn up with the FF and sayi want to try m with that. He's your cat!
A lot of cats arrive home not eating much. You will need to get some antinausea medication that I mentioned above from the vet before he leaves hospital and you may need to syringe feed. They may consider putting a tube in until his appetite returns.
It is VERY common for cats with ketones and DKA to have no appetite for a while but it does eventually return.


If he did a urine culture that should show any infection.
They can do a Fructosamine test without eating. It is a blood test.

Best wishes to your father for his surgery.
You have a lot on your plate at the moment.

Thank you for your wishes. I’ll update you once I see him today.

 

[Ann & Scatcats]

Oh what a Beauty Cutie he is!

 

[Bron and Sheba (GA)]

He is a beautiful kitty! if we can help
You with any of the questions just let us know.
Most important ones are about antinausea medications, type of insulin, if his blood tests are stable when they are ready for discharge.

the fructosamine test only tells you if he is a Diabetic or not. I don’t think there is any doubt he’s a diabetic with high ketones.

 

[Sarah97]

Update: the doctor just called and said his ketone and BG levels are still high even after IV. He developed respiratory pneumonia. Vet said I should be ready for anything and his life is at risk.
my heart is aching

 

[Ann & Scatcats]

Update: the doctor just called and said his ketone and BG levels are still high even after IV. He developed respiratory pneumonia. Vet said I should be ready for anything and his life is at risk.
my heart is aching

Oh. Such bad turn for the worst. I hope they find the right antibiotics and he turns around and come back well to you. Hugs

 

[Bron and Sheba (GA)]

Oh I am so sorry. I hope they can help him.

 

[Nan & Amber (GA)]

 

[Juls and Billy]

So sorry to hear Tiggo is having such trouble. I'll be keeping you and Tiggo in my thoughts.

 

[jt and trouble (GA)]

Adding Tiggo to my prayer list. sigh

 

[Ann & Scatcats]

Sarah, how are you and Tiggo doing? Very worried about you.

 

[Sarah97]

Sarah, how are you and Tiggo doing? Very worried about you.

Hello,
It been almost a week and Tiggo is scheduled to come out tomorrow or Monday . Thankfully he’s doing better. Not fully recovered yet.
I’m having troubles with his Vet.
As expected he wants me to feed him RC dry and give him intermediated acting insulin. I tried telling him that I have been reading lots and I would like to give him FF wet and put him on Lantus or Levemir. He was offended, and said he knows better and he goes by the book. So my question is:
Can I give my cat FF wet food if she’s taking intermediate acting insulin? And if the vet is monitoring her BG whiles she’s on RC diabetic dry food should the insulin dose be adjusted for wet food? Her vet was keen on me giving her wet food. He says that the dry food formula(even though it has higher carbs) it’s formulated to decrease the risk of other diseases that could arise from diabetes.
I’m scared he will have a blood sugar drop

 

[Bron and Sheba (GA)]

Sarah...I am SO glad Tigger is much better. That is great news.
Because of the ketones your vet is correct.
The vet (is this your ER vet or your regular vet) who wants to continue with the intermediate acting insulin, is probably wanting to do that because of the recent ketones (and I would think he had DKA as well) and this is a good idea until Tigger is completely over the illness.
The reason is because it is really important that Tigger gets his insulin and if you swapped to Lantus at the moment it will take a few days for the depot to build up and the dose to take its full effect, and we need to make sure there is no reduction in the insulin at the moment. You can swap over to the Lantus a bit later on when everything has settled down.
When Tigger has had ketones and / or DKA it is really important that he gets his insulin and plenty of food and any infection has been treated to stop ketones developing again

With the food it won't hurt to keep giving the R.C Dry for a few days while we see what his BG levels are doing. In the long run, yes you would want to swap over to something like fancy feast but in the meantime, it won't hurt to stay on the dry so that he can get a higher dose of insulin. You could ask if they have the RC in canned and ask for a couple of cans of that.
You are right that if you give low carb wet, you would most likely need to give less insulin.

However I do not agree with your vet saying that the RC dry is formulated to stop other diseases arising from diabetes.......that is a load of rubbish.

What I would do if I were you, is to go out and buy a human glucose meter from Walmart or a pharmacy and learn to test the blood glucose levels....it is not hard and we all do it here. That way you can keep Tigger safe from dropping too low. Walmart has a ReliOn meter which is fine and you will also need test strips to go with the meter and some 26 or 28 gauge lancets.
Also buy a bottle of Ketostix to test for ketones once he comes home...this is important.

I can tell you more tomorrow about how to prepare for his homecoming...I am just heading off to bed at the moment.
Here is a link with useful links. If you can get your spreadsheet and signature set up before he comes home and get the glucose meter and Ketostix as well, that will be a great help for when he comes home and we can help you with everything.
http://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/