11/25 Not eating

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Amanda & Ham

Amanda & Ham

Member Since 2017
Hey guys I know it's been a while since I've been on all has been well and I have been extremely busy. So I had been talking about finding a new vetty, which I did 3 weeks ago. Ham wasn't eating his meals. Sometimes he'd eat the whole thing and sometimes he'd only eat a bite or two.

Ok so this new vetty, I took Ham in on a Thursday and as soon as I told him that Ham was diabetic he said lets do blood work and check his kidneys and liver. I thought great. The vet also agreed that Ham did need some dental work. He came out 20 min later and said Ham was dehydrated and his red blood cells were down he wanted to keep him and give him fluids and an antibiotic then check him in the morning. I said sure, the next day Ham was doing better and eating for them so I picked him up. And here where I started to wonder if Ham doesn't like them. They said Ham had made a mess of himself and they didn't think they could get it cleaned up... I said no worries I can give him a bath. I got him home and it was almost like he sprayed poop all over his hind end. Ham has never done this ever! But he was eating.

A week later I had taken him back to get the dental done. His eating was back to the same. I dropped him off in the morning and picked him up that night. This time he had bloody fur under his chin. The vetty said some drooling blood was to be expected. I got him home and realized it was also on the outside of his carrier.

This now leads us to this week. Thursday Ham barley ate. He'd eat a bite or two here and there, but not enough to amount to much he wouldn't even eat turkey. Friday morning I got up and got ready to check Ham's BG's and he didn't come when I called him which was strange. I checked it and his BG was 122 (if I recall correctly) I got up to get food by time i had gotten his food ready he was back in his favorite spot in the closet. I called the vetty and took him back in. He did a glucose check and gave him a shot of Onsior and sent me home with Mirtazapine tablets (appetite stimulant). He had asked about keeping Ham again but I couldn't afford it for a third week in a row. Ham and I got home last night and he ate his whole dinner and a couple bites of his middle meal. But this morning we are back to didn't come when I called and wants no part of his food! So I gave him a pill maybe he'll eat in a little bit.

I don't know what to do anymore. I feel like I am back at square one. The vet tells me not to check Ham's BG "it's not accurate with that meter" I said yes I understand that but it's better then shooting blind. Yesterday when I checked Ham's BG I got numbers in the 120's the vet said he was 230 something.

I am sorry this is so long. If anyone can give me any ideas on how to get this cat to eat I am all ears. If he's not eating by this afternoon then I'm gonna have to force feed him. And neither one of us like it.
 
Ham's BGs have come down really well! However, not eating is a problem as you know. Many people here have said that giving an appetite stimulant without antinausea meds (cerenia, etc.) doesn't work very well. Could the antibiotic be making him feel unwell? Mouth still sore from dental? What did the bloodwork show aside from low red blood cells and dehydration?

It's not surprising that Ham's BG was higher at the vet's - stress, pet meter, etc. We'd all disagree with your vet about testing with a human meter so don't let him stop you! Given all he's been through the last week plus, his SS looks good. Let's see what the Lantus pros have to say. :)
 
The vet thought the antibiotic would make him feel better. I asked about his mouth... I was thinking maybe something got stuck in there or maybe it was infected, but he said no it's healed and Ham's gums are nice and pink.

I'm really not sure how to read his bloodwork... I'll try to post it give me a min.
 
Amanda & Ham said:
The vet thought the antibiotic would make him feel better. I asked about his mouth... I was thinking maybe something got stuck in there or maybe it was infected, but he said no it's healed and Ham's gums are nice and pink.

I'm really not sure how to read his bloodwork... I'll try to post it give me a min.
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There are some folks here who are skilled at interpreting bloodwork. @Marje and Gracie is one.
 
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Unfortunately, the labs aren't readable. I can't find a way to increase the size of the image. Most of us transfer the information (lab value and reference range) to our spreadsheet. Take look at Gabby's SS for an example. The labs are on a separate tab. It does look like there are some out-of-range values but I can't tell what they are.

How is Ham's behavior other than not eating? Is he "meatloafing?" One possibility, especially with a diabetic cat, is that he's having a bout of pancreatitis. Given that I'm having problems reading the labs, was either a SNAP fPL or SPEC fPL run? These are specific tests for pancreatitis. If Ham is having a bout of p'titis, it's likely he's in pain and nauseated. Buprenophine is a better choice for pain management than Onsior and you would want either ondansatron or Cerenia to address the nausea. Giving an appetite stimulant to a nauseated cat is a great way to cause a food aversion if you've not been able to do something to address the nausea.

I'm not a fan of prescribing antibiotics unless there's clearly an infection. Most vets will prescribe an antibiotic after dental work but usually only if there were extractions. Did the vet get any pre-dental and/or post-dental X-rays? The latter are particularly important if there were extractions and it looks like Ham lost a tooth. If there were any roots still left, that can cause a problem and be painful.

Getting labs before a dental is standard. It was a good idea for a new vet to get baseline labs on your cat regardless of FD or the need for a dental. I haven't a clue why the vet would want to keep Ham overnight to give fluids. Unless he was giving IV fluids, many of us have given fluids at home. They are typically given subcutaneously (just like insulin although the quantity is larger) and don't require a hospital stay.

Is there any chance that Ham is eating outdoors? If he's either hunting or finding food at a neighbor's house, it may explain his less than stellar appetite at home.

Diarrhea after having been given an antibiotic is not unusual. What is unusual is that the vet didn't clean up your cat either from the diarrhea or after the dental. There was sufficient time between the end of the procedure and your arrival that the vet should have cleaned up Ham's face and the carrier. At least for me, that lack of attention wouldn't inspire a great deal of confidence. It's very unprofessional.

 
I was able to click on the labs which then opened another window where I could use ctrl + to enlarge them.
Did the vet say anything about the blood work results? I am concerned about the low HCT and RBC, but @Marje and Gracie knows way more about blood work than me.
 
If the RBC is red blood cells then yes that's why they kept him 3 weeks ago. They gave him Cefazolin, Zeniquin, Onsior, IV fluids, and fluids subcutaneous (sub q fluids?)
 
He’s got an infection. The question is what type and if a culture was done. The bleeding could bring down the rbc. His white count is elevated. Kidney numbers look good. The antibiotic will eventually make him feel better but can cause diarrhea and nausea. I’m guessing there is a infection from the dental or caused by the bad teeth. Max had dentals with teeth pulled but never bled when I picked him up. Cats can get dehydrated quickly when not eating and also can get fatty liver. I’m also wondering why you weren’t sent home with pain medication which I was always given after surgery of any kind. Labs should have been done before he went home too. Have you tried baby food? You have to get enough food into him as even that can cause nausea. I’d be calling the vet.

I’m so sorry this is happening. :bighug:
 
@tiffmaxee - Elise, i'm not sure I see conclusive evidence of an infection. The WBC is normal. What did you see that I'm missing? Were you assuming that there was something inflammatory going on due to the extraction? The vet did give an Rx for Onsior but it sounds like it was a one time dose (and certainly shouldn't be prescribed for more than a couple of doses). FWIW, my vets rarely do post-procedure labs. It's been more important to know that were aren't problems before the procedure since it's unlikely that something will change after. They usually have a brief window regarding how long a set of pre-procedure labs are reliable, though.
 
Just my two cents, sounds like you have a couple of red flags with this new vet, maybe keep shopping for a better one. I've been vet shopping recently too, and one of the vets I went to had nothing but dog photos everywhere, they seemed afraid of cats and threw a towel on Asia and held her down firmly and unnecessarily just to look her over (she's 21, she's friendly, and you can safely do just about anything to her besides go in her mouth). That was the first and last time Asia has been there. I hope you can get her eating soon, and maybe a 2nd opinion from a different vet. :bighug:
 
Sienne and Gabby (GA) said:
@tiffmaxee - Elise, i'm not sure I see conclusive evidence of an infection. The WBC is normal. What did you see that I'm missing? Were you assuming that there was something inflammatory going on due to the extraction? The vet did give an Rx for Onsior but it sounds like it was a one time dose (and certainly shouldn't be prescribed for more than a couple of doses). FWIW, my vets rarely do post-procedure labs. It's been more important to know that were aren't problems before the procedure since it's unlikely that something will change after. They usually have a brief window regarding how long a set of pre-procedure labs are reliable, though.
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I was looking at the high mono. I misunderstood and thought he was hospitalized. My vet wouldn’t have rechecked the labs either. You are right Sienne. He does sound anemic with pale gums. I’m hoping it’s all a reaction to the antibiotic.

I hope the vet has the answers. :bighug: Keep us posted.
 
He is anemic... even more then a couple weeks ago. They can't give him steroids due to being diabetic.

They gave him an injection of Cerenia and sent me home with Sucralfate and told me to pick up some Omeprazole from Walmart
 
Has your vet ever ordered an SDMA? It looks like Ham's creatinine, BUN and phosphorus levels have risen between now and earlier this month. It may be an artifact of dehydration and nothing to worry about or it may be reflective of kidney issues. The SDMA is a test that will let you know if there are early kidney issues. Anemia is also associated with kidney issues.

Has the vet determined what the cause of the anemia is? Steroids are typically used if the anemia is a result of an autoimmune problem. You really need to know the cause in order to treat the problem. Frankly, while steroids can be problematic for a diabetic, you can work the insulin around steroid treatment. I would encourage you to get the vet working on the cause for the anemia. The anemia may be contributing to Ham's loss of appetite, too.

 
No they have not ordered a SDMA. They aren't sure what's causing the anemia the vet today was talking about it could be his spleen, it could be cancer. she had no clue and wanted to keep him over night and I said that was pointless due to them being closed tomorrow and no one would be there. I can give him his meds and insulin and force feed him at home and keep an eye on him.... not that I'd know what to do. Since we've been home I have gotten him to eat a little turkey force feed him twice (a tiny bit each time) and got him to drink some water.

I really wish I knew more about what was going on with him. I feel like an idiot relying on the vet... sometimes I feel they are making crap up.
 
I think I agree with Ham -- I'm not sure I like this vet. What is the point of all of the overnight stays? It's not like he's critically ill and needs monitoring 24/7. Nor do any of these tests involve anything more than a blood draw. Most kitties are not happy being away from their territory and their routine.

Where are you located? Maybe there's a member either here or on the Health board who has a vet they trust. If your gut is screaming at you, I'd say trust your gut.

(FYI, there's Snap SDMA. It's like a pregnancy test -- it will give immediate "yes or no" results. The advantage of sending the blood out, though, is you get an actual reading. Your vet sends labs out to IDEXX and that's where the blood needs to go.)
 
it may not be ideal, but what about looking for a vet in Cleveland? it looks like there's a cats only practice in South Euclid (Just Cats Hospital). At least according to Google, it's about a 30 min. drive. It could take me that long to get to my vet when I lived in Chicago.
 
Sorry to just get here now but Ham is not just anemic....he is severely anemic. None of the meds she gave him will address his anemia. It appears to be regenerative anemia because his reticulocytes are so high but, for where his HCT is (very low), he probably needs some help. There can be many things that can cause this kind of anemia. The sulcrafate might help with any GI bleeding but they need to figure out why he is anemic. If he were mine, I wouldn’t give him omeprazole......she hasn’t diagnosed why he needs it. It’s an anti acid like pepcid. I would try and get cerenia pills and also some ondansetron in case he is nauseated and I wouldn’t use the mirtazapine until I made sure the nausea was addressed.

If he were mine, I’d take all these labs and get him to a different vet or an ER. That anemia really needs to be addressed immediately. It can cause a whole cascade of issues.

Many vines and prayers.
 
The new vet gave him Convenia and Dexamethasone to try to raise him RBC and get him to eat... She said he has a mass in his stomach that can either be a tumor or an enlarged spleen. No way to know for sure without an ultra-sound and I can afford that right at this moment. And I'm not sure I can afford to treat either.. but we're not there yet.
 
Amanda & Ham said:
The new vet gave him Convenia and Dexamethasone to try to raise him RBC and get him to eat... She said he has a mass in his stomach that can either be a tumor or an enlarged spleen. No way to know for sure without an ultra-sound and I can afford that right at this moment. And I'm not sure I can afford to treat either.. but we're not there yet.
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I'm sorry, Amanda. :bighug:

What was your feel on this vet? Did they say if/how they would treat either of those conditions without an ultrasound? Did they think that was the definitive cause of the anemia? How is Ham feeling right now? Is he eating? Is he home with you?
 
I feel better about this vet. She didn't say either way... she was real concerned about him and even more concerned about giving him the steroid. I have to call her in the morning and give her an update.

He is home with me... He did eat... I think he's feeling good, he has been out more today then he has been all weekend.

Thank you everyone for the help and support.
 
Amanda & Ham said:
I feel better about this vet. She didn't say either way... she was real concerned about him and even more concerned about giving him the steroid. I have to call her in the morning and give her an update.

He is home with me... He did eat... I think he's feeling good, he has been out more today then he has been all weekend.

Thank you everyone for the help and support.
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Glad you got good feels on the vet, it really makes a difference. I'm happy Ham is eating for you and being active. I hope whatever is going on with him can be managed and he can stay happy. Please keep us updated if you can, I'm sure I'm not alone in saying I quickly get attached to other people's kitties and wonder how they are doing. :bighug:
 
The dexamethazone is a powerful steroid often used to treat immune mediated hemolytic anemia as it suppresses the immune system response. I hope they can find out the cause of the anemia so they can properly address it.

Not sure why she gave the Convenia. It’s not the best broad spectrum antibiotic.

Sending more vines form Ham.
 
I'm glad he's home and eating and feeling better. Sending vines for this to continue.
 
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