10/24 Crushy vet visit.....need advice!

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Michele M

Michele M

Member Since 2013
previvious http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=106836&p=1132771#p1132771

His appetite is WAY off. This morning I had to bring him over to his shot meal twice before he would eat it (he never misses a meal....this is very unusual behavior) and he completely turned down the treat he gets with his shot.

Ive been feeding him at PS +1 +2 +3....he ate the PS meal today but has so far refused his +1 and +2 meal and all treats. So he's had 1/2 oz today so far.

his BG is still high so no worries about going too low. Still......this is worrisome

He is sort of walking around slowly too like he doesnt feel well. No excessive drinking but he did complain a bit when I picked him up. I dont think it was a 'Im in pain" meow, but more of a "leave me alone I dont feel well" meow.

I havent been able to get a ketone test yet today...still trying

really hoping this is just a hairball or something....
 
Re: 10/24 Crushy amps 337 +2 354 +3 349 refusing food

Im starting to get really worried.

This is extremely atypical behavior for him to not eat

he has only eaten 1/2 oz of food in the last 24 hours

and he's acting like he doesnt feel well
 
Re: 10/24 Crushy amps 337 +2 354 +3 349 refusing food

Get a ketone test ASAP, and if he shows any problems, call your vet.
Does Crushy have pancreatitis, IBD, or any other sort of tummy trouble? Do you have bupe for him, and have you given him any?
If you feel very worried, bring him to the vet. Depending on how worried you are and how atypical this is for him - as he's showing you signs that something is not well - this is the best course of action.

Wishing the best for you and Crushy!
Poor you!
 
Re: 10/24 Crushy amps 337 +2 354 +3 349 refusing food

I called the vet and the earliest they can get me in is tomorrow morning

they suggested I try to syringe feed him if he continues to not eat

he dosent have pancreatitis, IBD or any tummy trouble I know of. I dont have any Bupe....

Still trying to get a ketone test.
He's not drinking either.....

He keeps licking his lips a lot too.....does that mean anything?
 
Re: 10/24 Crushy amps 337 +2 354 +3 349 refusing food

Lip licking usually means nausea...maybe your vet will give you a shot of something to relieve the nausea until he can get in to be seen?

Poor Crushy...feel better soon buddy!!
 
Re: 10/24 Crushy amps 337 +2 354 +3 349 refusing food

yep, he just threw up

looks like everything he at at amps

ugh.
 
Re: 10/24 Crushy amps 337 +2 354 +3 349 refusing food

Good for the throwing up, because that might have solved the problem - I hope so for both of you.

Try to see if he'll eat baby food, or heat some water and add a couple tsps to some wet food, to heat it up a tad and make it more soupy for him. Even if he can eat just a little lick now and then, that's good enough.
 
Re: 10/24 Crushy amps 337 +2 354 +3 349 refusing food

Baby food (Gerber or Beechnut stage 2 -- it's meat and broth, no veggies) is always a good option if Crushy's not feeling great. You could also give him 1/4 of a 10 mg tablet of Pepsid AC. It might help to settle his stomach. If you try to feed and he throws up again, you might want to call your vet to make sure it's OK to give Pepsid. If throwing up persists, it might mean a trip to the ER.

Unless there's more vomiting, I'd keep a close eye on Crushy. As was suggested, getting a ketone test is important in a cat that doesn't feel well and isn't eating.
 
Re: 10/24 Crushy amps 337 +2 354 +3 349 refusing food

Hi Michelle, How is Crushy doing? Did he eat any baby food?
 
Re: 10/24 Crushy amps 337 +2 354 +3 349 refusing food

OMG Michele. Poor Crushy. And poor YOU.

I am just walking in. Is he any better yet? yes, lip licking usually means nausea. Has he thrown up again?
Wonder if he could have gotten into something. (bad rodent?)


It is true FD kitties are prone to pancreatitis. Marje ha s primer online if you haven't see it. http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=79693

You already got great suggestions for in the meantime. You want to try and get some food in him. Hank was not eating well at all after his dental, but also because his tummy was SO messed up and upset from 2 weeks of ABS. This went on for awhile. I tried all of it. He did like the baby food the first couple times. That is easy to find at HEB. I warmed his food, sprinkled Fortiflora on it,- do you have any? Brought it to him..all those things.

How are things now. Do you need anything?
 
Re: 10/24 Crushy amps 337 +2 354 +3 349 refusing food

I would put a light layer of plastic wrap on top of the litter in the litter box just in case he goes and you miss it, at least you have a sample to test. I am sending strong feel better vines to Crushy.
 
Re: 10/24 Crushy amps 337 +2 354 +3 349 refusing food

Just adding our prayers to the pile...I hope Crushy is feeling better by now.
 
Re: 10/24 Crushy vet visit...need advice

So I took Crushy to the vet. (not my normal vet, he didnt have anything available) Neither my husband nor I were super impressed by the guy we ended up with (the fact that he looked and sounded exactly like Badger from the TV show Breaking Bad didnt help) and we are still unsure what to do. Im hoping you guys can shed some light on this

They said his urine ketones were negative, but his plasma ketones were "slightly pink"

so he has Plasma Ketones (not really sure what "slightly pink" means....we didnt see that wording until we got home)

The vet wanted us to take him to the emergency clinic to start treatment for ketones tonight. BUT he also said that usually when they are treating cats for ketones if all they have are the plasma ketones and they are eating, then they try to put them back on long acting insulin. Crushy ate a bunch of chicken while we were at the vet....so he's eating!

So we brought him home. We have an appt with our regular vet tomorrow morning. But Im wondering if you guys have any thoughts about whether he does indeed need to go to the emergency clinic tonight. He's eating and drinking fine now (and looking thoroughly relieved to be home....we were there for over 2 hours)

There was no bacteria or crystals in his urine

his BG was 417 while he was there (stress)

RDW was 28.6 (Normal is 15.0 - 27.0)
EOS was .11 K/uL (normal is 0.17 - 1.57)
potassium was 3.3 mmol/l (normal is 3.5-5.8)
BUN was 14 mg/dl (normal 16-36)
all other tests were normal (I dont even know what RDW and EOS are!)

my head is spinning and Im way too emotionally involved in this to be objective. My husband has a pretty good BS meter and he was convinced this vet was just trying to cover his ass and/or bill us to death. He did at one point suggest we put him on science diet and thats when I said....nope I want a second opinion on all this and we came home. He was also super critical about how often I'd changed Crushy's insulin dose. *sigh*

If need be we can pack him up and take him to the Emergency clinic...I just want it to be necessary

Im also wondering if moving his feeding times to PS +1 +2 +3 may have just given him too much time without food during the day? I dont know....

thoughts?
 
Re: 10/24 Crushy vet visit.....need advice!!!

Plasma ketones come before they show up in urine. It sounds like the vet thinks he's trying to go into ketosis, and wants you to get him to the ER vet. I'm not sure what's meant by "pink"

If he's EATING, that should help since lack of carbs is one of the reasons ketones are produced.

I'd probably watch him closely, make sure he's eating, check his BG often and make sure it doesn't go crazy high, and test his urine often...and if you smell acetone on his breath or any of the urine ketone tests come back positive, get him to the ER vet immediately.

"When the rate of synthesis of ketone bodies exceeds the rate of utilization, their concentration in blood increases; this is known as ketonemia. This is followed by ketonuria – excretion of ketone bodies in urine. The overall picture of ketonemia and ketonuria is commonly referred as ketosis. Smell of acetone in breath is a common feature in ketosis."

Will be praying for Crushy to be safe and healthy, no matter what you end up doing.
 
Re: 10/24 Crushy vet visit.....need advice!!!

If he's eating and drinking, take him to your normal, intelligent vet tomorrow.
See if you can get an ultrasound, and a Spec fPL test, for pancreatitis.
Buy some Pepcid AC at a drugstore, and give Crushy 1/4 a half hour before his first meal, for a few days.
Relax now and everybody hug, and have a good evening.
 
Re: 10/24 Crushy vet visit.....need advice!!!

thanks you guys

he doesnt have acetone breath and is eating so thats good
and Ill ask about the pancreatitis tests tomorrow
 
Re: 10/24 Crushy vet visit.....need advice!!!

One thought is can you call the ER clinic ...tell them what this vet said about Plasma ketones vs urine keytones.
1) Does slightly pink concern them such that they would think you should bring him in.
2) How would they be treating and what would they be doing if you did bring him?

Let them know this was not your normal Doc. and you are not sure you have confidence in his opinion. You have an appt. scheduled with regular vet in AM.

If they do NOT think you should bring him in, ask what you should be doing or can do in meantime. and is there anything in particular you should be watching for.


He ate chicken at the vet?..a bunch? So odd after not eating all day. You brought food with?
This probalby will already help him to feel better.

Ok. I also still think to get some baby food. You can get gerber stage 2/ turkey& broth at HEB. there is something about the smell and consistency they really like.

If you do call the emergency clinic I recommend the one on North 183. Is that much further from you than the south one?

So sorry Michele, I know it's scary.

Feel better vines for both of you.
 
Re: 10/24 Crushy vet visit.....need advice!!!

EOS is the eosinophil count. This is one of the types of red blood cells. A low count is usually not of concern. It may be indicative of allergy.

RDW is the width of red blood cells. What the result means is that there is greater variability in the width of the cells than what's typically expected. It may reflect a B12 and or iron deficiency (i.e., anemia). However, if all of the other red counts are normal, I would discuss this with your vet tomorrow.

For tonight, add as much water as Crushy will tolerate into his food. If there are ketones developing, water will help to flush them. Ketones develop if there is an infection/inflammation present, your cat's not eating, and if more insulin is needed. What you should understand is that a blood/plasma ketone test will register the presence of ketones well in advance of them showing up in the urine. It takes hours for urine to form and be excreted whereas a blood test gives you an immediate result. (It's the same if you are getting a BG vs. a urinary glucose test. Blood tests for ketones yield a number, not a color so I don't know what that result means, either. What surprises me is that if the vet was so concerned about ketones, why he didn't give Crushy fluids. What I'd suggest is that you test for ketones. If you get a result that is more than trace, it may require a trip to the ER.
 
Re: 10/24 Crushy vet visit.....need advice!!!

the emergency vet closest to me is the south one near Central Market

I dont really trust them enough to get their advice on this though. I'd rather wait and see what my regular vet says. Early on when I first started BG testing Crushy I got a reading in the 400s and freaked out and called South Emergency clinic. They said I needed to bring him in immediately....like it was a dire emergency. Keep in mind this was just a spot check and I have no idea what his numbers were the rest of the day (considering how he bounces it was probably really low a couple hours earlier.) So id I called them now they would probably just tell me to bring him in.

At the vet today my husband was eating some chicken salad (he hadnt eaten all day) and Crushy started acting like he was interested in it. So we told the vet tech and they brought us two little trays of chicken. Crushy scarfed them both up really quickly. Im guessing throwing up did help him like Lara suggested. That or the shock of being at the vet somehow brought his appetite back. He's eaten well since he came home too though.

Ill grab some of that baby food to have on hand just in case though.
 
Re: 10/24 Crushy vet visit.....need advice!!!

thanks Sienne

I was wondering about that color reading too. Sounded like a trace reading to me but I dont know. He's had a lot of water since he's been home (he headed straight for the water bowl when I put him down) but Ill put more in his food too.

Do you think that moving his feeding times to early in the cycle and no food for 9 or so hours during the day may encourage ketones to develop at all? I keep wondering about that....
 
Re: 10/24 Crushy vet visit.....need advice!!!

I doubt that front loading the cycle effects ketones. If it did, Gabby would be one sick kitty. I feed at pre-shot, +1, +2 and +3. She rarely gets food later than +3. Ketones don't occur because a cat is hungry. Loss of appetite is more the issue where food is concerned. Beyond not eating, it's a combination of other factors (infection and insufficient insulin) that lead to the development of ketones.
 
the vet suggested that ketones in the plasma doesnt happen quickly. Is that true? or would missing a few meals just today cause that? His appetite is normally very good. I keep looking at his SS and he spends so much time in the 300s. Pink is the predominant color in his chart. Yet his dose keeps coming down because of occasional dips. This is kind of concerning no? if one of the reasons for ketones is insufficient insulin and I keep having to lower the dose.

As far as we can tell so far there is no sign of infection. Though pancreatitis has not been ruled out yet

Im also wondering about other insulins at this point. OR do I need to give lantus more time?
 
Re: 10/24 Crushy vet visit.....need advice!!!

sorry...just now catching up. So funny that the vet had little trays of chicken!..or is that just me?

Is he eating since he's been home. Seem any better?

it really may be just an upset tummy. Let's hope that;s it.

I have called that ER vet south also. And btw just like you called when i got a 180-something on a weekend in the first day or two of insulin and didn't know whether or not to shoot. They must get crazies like us all the time. lol. I think many of the vets also prefer the north one. It's only 5 minutes or so from Mopac/360 so not too bad. Hank has been treated there a couple times.
The specialty vet hospital down by Central Market south is supposed to be wonderful- but you have to be referred..

Hope he is feeling better and ya'll are able to get some rest.

Please report back as soon as you can and after the vet visit.
 
Re: 10/24 Crushy vet visit.....need advice!!!

SO happy to hear Crushy is eating and drinking better!! Is he acting like he feels better too?

Come on Crushy...we're all here for you!!


the vet suggested that ketones in the plasma doesnt happen quickly. Is that true?
Click to expand...

Sounds a little strange to me...If a cat can have a negative urine ketone test at night, and a trace ketone test in the morning (and be quite sick), it would seem that urine ketones can add up quickly, so it make sense that if they show up in the blood first, that it IS happening quickly.

They'd show up in the blood first, get to a level where they'd start showing up in the urine...If the urine ketones can go up quickly, it just seems reasonable that the blood ketones would be able to go up quickly too.
 
Re: 10/24 Crushy vet visit.....need advice!!!

yep he is acting like he's feeling better
Eating and drinking just fine now
 
I would continue to watch him tonight and be sure he's eating and drinking as others have suggested. Ketones can develop quickly so it's important to keep an eye on them.

You need to give Lantus more time. The other insulins are shorter acting although Prozinc is a medium duration insulin. The other longer duration insulin is levemir but I think he just needs more time on Lantus.

I also think changing his feeding schedule would not be responsible for this. I'd just be sure the vet checks him over closely tomorrow including his mouth to be sure there's nothing going on there.

Sending him healing vines.
 
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