12/22 New member - introducing my cat Loki - rough day

[Elizabeth and Loki]

We are about 4 weeks into this journey. Probably longer, but that is from diagnosis. Loki will be 14 in March. A couple of months ago I noticed some behavior changes. For his whole life he loved to sit on my lap, especially every morning, but he stopped doing that. Then I noticed he had lost weight so I scheduled a checkup.

His glucose was over 500 so we started him on Lantus at 2 units twice a day. We started feeding him low carb canned food only. He was very hungry and thirsty all the time. After a week the vet did a glucose curve. His numbers dropped very low so the vet thought the diet change might be enough. We did a week with no insulin. Back at the vet, his first reading was back over 500, so we started back on Lantus 1 unit twice a day. After a week we did another curve and his numbers were still high so we increased the dose to 1.5 units twice a day.

We also bought a baby scale and he has lost weight steadily. Today for the first time he had no appetite. I can tell he isn’t feeling well. We talked to the vet who thinks we should continue doing what we’re doing for another week or two and see how things go.

After reading here a bit, I am starting to understand that to regulate Loki’s diabetes we should start home testing, because I have no idea if his symptoms are related to his glucose being too high, too low, or something else entirely.

Right now I’m just so scared that we are losing him.

 

[Bron and Sheba (GA)]

Hi and welcome Elizabeth and Loki. You have come to the best possible place to help your kitty.

First of all, if he is not eating, I would go out and buy a bottle of Ketostix from Walmart or a pharmacy and test his urine for ketones. Anything above a trace needs immediate vet attention. It is an easy test, collect a urine sample from Loki, then dip the test strip into the urine and exactly 15 seconds later read the result against the colours on the side of the bottle. Ketones can form in unregulated diabetic cats and can lead to the much more serious DKA if not treated early. Not eating is a red flag so getting the ketones test done and hopefully being able to eliminate ketones would be good.

It is really important that he eats, so give him whatever he will eat until you have figured out what the problem is. Don’t worry if it is not a low carb food, the most important thing is he eats.
It is possible he has something like pancreatitis (which is very treatable) and he may need some antinausea medication. Cats won’t eat If they are nauseated. If he hasn’t started to eat by tomorrow morning I would take him to the vet and ask for a fPL test for pancreatitis and a ful blood count to see if anything is amiss. You don’t want this lingering over the Christmas break.

Offer him small amounts of food often, Here is a link to tempt his appetite
https://www.felinediabetes.com/FDMB/threads/suggestions-on-how-to-stimulate-kittys-appetite.130770/

Also a link on home testing...very glad to see you are wanting to home test. It will keep your kitty safe.
https://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

More later
Bron

 

[Bron and Sheba (GA)]

Newly diagnosed diabetic cats often lose weight as they are unregulated and are not able to utilise the nutrients properly. If he has lost weight, feed him small amounts often. Once the blood glucose levels are in more normal numbers, he will start to put on weight.

This link has useful information and links about hypos and how to recognise them and treat, how to set up a spreadsheet and how to set up the signature.
https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

Once you have set up your signature and spreadsheet and are able to test the blood glucose, we can help you with dosing and getting Loki regulated. But first your most pressing problem is sorting out why he is not wanting to eat and getting him eating again.
Ask lots of questions, we are very happy to answer them.

 

[Elizabeth and Loki]

Thank you. He made it through the night. I was afraid he wouldn’t. This morning he ate some breakfast and seems steadier, and his weight is the same as yesterday. He’s resting in his bed now, which is good because yesterday he would only lie on the floor.

I’ll get the test strips today and try to set up a signature and spreadsheet.

 

[tiffmaxee]

Please post when you can get test results.

 

[Elizabeth and Loki]

No ketones, BG in the 190 range, and a vet visit because he wasn’t eating more than a morsel. He got fluids and anti-nausea meds. The vet thinks whatever is wrong might be unrelated to diabetes and the next step would an ultrasound if he doesn’t improve. His labs were all fine except for the glucose. He’s sleeping now. I’m really hoping he will eat some dinner when he wakes up.

 

[phakewishard]

Welcome,
Loki is a very handsome man, and I am very glad you have found your way to this forum. I hope he eats after waking up and that the anti-nausea medicine helps him. I'm new, so I can't be much help, other than support. I don't know what would be causing his nausea with no other elevated lab work results, maybe the insulin is dropping him too fast? Other, more experienced owners can tell you for sure.

 

[tiffmaxee]

Were you sent home with any medication for nausea? I suspect he got a shot of cerenia and it lasts for 24 hours so you should have been given cerenia pills for the next 4 days,especially with Christmas and offices closed. I am surprised the vet didn’t test for pancreatitis. It’s a blood test that’s sent out. The in house one won’t show as pancreatitis if in the gray zone.

 

[Critter Mom]

Hi Elizabeth,

Loki is indeed a very handsome boy.

He’s resting in his bed now, which is good because yesterday he would only lie on the floor.

Is the floor a cooler place than other spots he likes to hang out?

What position does he adopt: lethargic sprawl or hunched up, tense meatloaf?


Mogs
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[Elizabeth and Loki]

Were you sent home with any medication for nausea? I suspect he got a shot of cerenia and it lasts for 24 hours so you should have been given cerenia pills for the next 4 days,especially with Christmas and offices closed. I am surprised the vet didn’t test for pancreatitis. It’s a blood test that’s sent out. The in house one won’t show as pancreatitis if in the gray zone.

Yes, he got a shot and we were sent home with pills for four days. The vet wants me to call tomorrow with an update, and I’ll ask about pancreatitis then. That may be one of the reasons for the ultrasound he mentioned. Loki did eat his dinner tonight and got his shot before going back to his bed.

 

[tiffmaxee]

That’s good. I’m glad he ate.

 

[Elizabeth and Loki]

Hi Elizabeth,

Loki is indeed a very handsome boy.


Is the floor a cooler place than other spots he likes to hang out?

What position does he adopt: lethargic sprawl or hunched up, tense meatloaf?


Mogs
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Thanks. We think he is beautiful and he normally has a sweet disposition, very friendly and affectionate.

The floor is probably cooler than his bed, but the sofa is where he mostly likes to sleep.

Right now he is curled up in his bed in a typical cat way. But for the past couple of days he has been more of an awkward meatloaf, not even asleep, just staring straight ahead.

My heart hurts. I want my sweet boy back. Is it terrible that I could accept letting him go if he is very sick but watching him suffer is unbearable.

 

[Critter Mom]

Hi Elizabeth,

But for the past couple of days he has been more of an awkward meatloaf, not even asleep, just staring straight ahead.

Here's a very helpful pictorial Feline Grimace Scale. It was developed following scientific research carried out by the University of Montreal and therefore is a valid professional tool for assessing a cat which you can use to provide indisputable feedback to your vet.

Also, based on my own experience, if a cat is experiencing digestive discomfort (as can happen for cats experiencing a flare of pancreatitis or IBD) they tend to sit in that hunched, tense meatloaf position - usually with a 'pinched' or depressed expression on their face - and seeking out cooler surfaces on which to sit or lie.

Based on your observations I'd recommend going back to your vet today and asking for both the instant SNAP fPL test and a Spec fPL test to determine whether pancreatitis may be an issue (if only to rule it out).

SNAP fPL: On-the-spot test (bit like a pregnancy test). Gives Yes/No/Unclear result. Advantage is that it's instant and, if positive, provides vet with concrete evidence of presence of pancreatitis and basis for treatment; disadvantage, as Elise mentions above, is that it can be inconclusive (but the additional Spec fPL can overcome this issue).

Spec fPL: Needs to be sent to a lab. Advantage is that it returns a numerical result by which severity of any inflammation may be gauged; disadvantage is that it takes longer to receive the result (and a vet may potentially delay treatment till then).

Bearing in mind that it's the holiday season and it can be trickier to get veterinary support, perhaps your vet would be willing to treat Loki 'as if' he is experiencing GI discomfort while waiting for test results and the proposed ultrasound and provide you with the appropriate prescriptions for home use. If it is pancreatitis then the following treatments are indicated:

• Anti-nausea meds (Cerenia and/or ondansetron).
  
• Appetite stimulant.
• Fluids (at vets/at home/adding extra water to food).
• A course of B12 injections (see TAMU protocol).
  
• Pain relief (buprenorphine).

The IDEXX feline pancreatitis treatment guidelines have full details of appropriate interventions. It's an excellent document upon which to base questions for and discussions with your vet.

Of course we here have no way of knowing whether or not Loki may have pancreatitis but it can be a frequent traveller with feline diabetes (both acute and chronic manifestations of the condition). By way of general information, based on my own experience with Saoirse and what I've read here about other members' cats who also had pancreatitis, while it may cause a kitty significant discomfort or pain at the height of the flare, pancreatitis can be managed and the cat made more comfortable with the appropriate treatments. Most importantly, flares do subside. It may take a little time, but cats feel and act a lot better afterwards. In Saoirse's case, she experienced an awful pancreatitis flare a few months after her diagnosis and at one stage I feared that she might never get better. Three months later she was in diabetic remission and climbing trees. (((Saoirse)))

I'm very glad you've found FDMB. We'll do all we can to help you both. I hope your handsome little fella feels much better very soon.

(((Elizabeth and Loki)))


Mogs
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[Elizabeth and Loki]

Thank you again. Loki seems better today. He ate a really good breakfast (his own and the other two cats’, who are not thrilled with the switch to canned food yet). He gained a couple of ounces, maybe because he’s less dehydrated. He came on my lap for a few minutes and even purred weakly (not his usual locomotive purr). Now he is sleeping on a blanket on the sofa in a comfortable cat curl. I’m cautiously hopeful that he is mending. We’ll keep him on the Cerenia over the weekend. I found out that the vet-tech daughter of a friend is working at the emergency clinic over the holiday, so I feel better having that option if he relapses.

Thanks again. Having someone to “talk” to really helped. My husband is very helpful with the shots, etc. but doesn’t really want to talk about it and gets frustrated with my relentless anxiety about the situation.

 

[Critter Mom]

I'm pleased and relieved to hear that Loki has been eating! (((Loki))) Appetite problems can be a real roller coaster. We're here any time you need an understanding ear: many of us know just how very hard and distressing it is when your little one won't/can't eat. Glad to hear that you feel a little better today too, Elizabeth.


Mogs
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