Caryl and Alex said:
He's going to need a shot of something to settle his stomach soon. What do we do about insulin when they can't eat or drink?
((((Jackson)))((((Alex))))
I'm sorry to hear they are so sick. I'd try and get an antiemetic (anti-nausea) from the vet for both of them. Injectable is preferable. My first choice for acute vomiting would be Cerenia/Maropitant, then Zofran/Ondansetron, or Reglan/Metoclopramide. In our experience, Cerenia does the best job at completely shutting down the ability to vomit. Vomiting can become cyclical, so it is best to get in with an antiemetic soon. If they are dehydrated, that can also make vomiting worse, and SQ fluids may help (if vet gives okay).
I had to deal with Sasha not eating/vomiting and insulin for a fairly long time, although she was not prone to ketones. Best case, I think, would be to get an antiemetic into Alex soon so that he may feel up to eating or so that you can syringe feed if absolutely necessary. When you do offer food, only give small bits of food at first. If you have or can get some baby food (we used Beechnut Stage 1 meat flavors often), that is nice and bland and appealing to many sick kitties.
Given that Alex is ketone prone, I would want to get as much insulin in him as possible without putting him in danger. Test often this cycle to see where he is headed. Make sure you have Karo on hand, which can be rubbed on the gums if he will not eat.
Has Alex kept anything down today?