? 2/8 Vesper (3 DKA episodes), AMPS 255, +4 266, PMPS 495, +3 359 - Vomiting - please advise

Kelly and Vesper

Kelly and Vesper

Member
Yesterday's post: https://felinediabetes.com/FDMB/thr...-398-new-to-group-and-dosage-question.298172/

Good morning, everyone. Thanks very much for your helpful responses on my thread yesterday. We are still new to this and in the process of learning, so we greatly appreciate everyone's patience.

I'm a bit concerned about Vesper this morning. She vomited last night (first time since her second DKA episode on January 22). I gave her an antinausea and she seemed okay during the night. She ate breakfast so I gave her her Lantus. About 2-3 hours after eating, she puked (up to about 4x) and, although interested in eating, cannot seem to keep any food down. I have tried twice to give her another antinausea and she has vomited it up both times. I'm feeling scared right now and unsure what to do. I will check her glucose in 20 min (at +4) and am waiting for her to urinate to check ketones. Any other advice? Should we take her into the ER?

Edit: I just pilled her with another antinausea instead of using a pill pocket and hoping she can keep it down this way. It has been about 10 min, fingers crossed.

Second edit: She puked again. I did not see the pill this time, so I cannot try another antinausea. She cannot seem to keep any food or water down. Just tested her urine, and it's negative for ketones.

Third edit: In reviewing Vesper's chart notes from her follow-up vet visit yesterday, I noticed that her "lact" blood test was high. The range is 0.5-3.2 and her result was 4.81. Her BUN was also slightly high (34) with the highest range being 32. And her "Be(ecf)" value was low at -6.1. Anyone have insight into these results? The vet didn't say anything to us about them.

Our original post: https://www.felinediabetes.com/FDMB...ssible-euthanasia.297847/page-2?_params=Array
 
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I'm not experienced enough to have any advice for you, so hopefully someone else will be in here soon, but I just wanted to pop in. Poor Vesper! That sounds absolutely miserable. Thinking of your sweet girl and hope she's okay and feeling better soon!
 
Kelly and Vesper said:
Update #4: She just eagerly ate and immediately puked again. Would love some insight, or I'm thinking we have to take her to the ER.
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Hi Kelly, I'm sorry Vesper is so ill. I'm not sure if you've gone to the ER or not.

In case you have not and are still waiting for someone to weigh in: if you will click the "thread tools" + "edit title" + "no prefix" + "?" your question might be more visible to the moderators. I'm going to tag a few folks for you: @Angela & Cleo @Wendy&Neko @Bron and Sheba (GA) @Bandit's Mom

Good luck with getting some relief for your precious baby!
 
Marielle said:
Hi Kelly, I'm sorry Vesper is so ill. I'm not sure if you've gone to the ER or not.

In case you have not and are still waiting for someone to weigh in: if you will click the "thread tools" + "edit title" + "no prefix" + "?" your question might be more visible to the moderators. I'm going to tag a few folks for you: @Angela & Cleo @Wendy&Neko @Bron and Sheba (GA) @Bandit's Mom

Good luck with getting some relief for your precious baby!
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Thank you! We are at the ER now, waiting to be seen.
 
I am just up and reading this Kelly. I am so sorry Vesper is vomiting. I am glad you have taken her to the ER. Hopefully she will just need an injection of the vomiting. I wonder what is causing the vomiting?
That is reassuring there are no ketones. please let us know how things go. We are anxiously waiting to hear.
 
Thank you! We are home from the ER. I really liked this vet, and his cat also has diabetes and is on Lantus. Given that Vesper had a fair amount of bloodwork done yesterday at her checkup, and had full workups for her DKA episodes last week, he didn't see a need to do another full workup (especially given that she would need to be fully sedated, which carries risks). He let me draw her blood to recheck her lactate level (which was one of her abnormal results yesterday), and it was normal. He also gave her a cerenia injection. He said if she vomits on the cerenia, then she must be brought back in. So we are just hoping that does the trick.

He said cerenia can take about an hour to work, so I'm wondering when I should try feeding her? She is definitely hungry. She had the injection about 40 min ago.

He also suggested giving her 1.5 of Lantus tonight as long as she is eating, and even giving her 1 unit if she is not eating (as long as her BG is above 250).

So grateful for all the support from this group. It helps me feel so empowered!
 
Kelly and Vesper said:
Thank you! We are home from the ER. I really liked this vet, and his cat also has diabetes and is on Lantus. Given that Vesper had a fair amount of bloodwork done yesterday at her checkup, and had full workups for her DKA episodes last week, he didn't see a need to do another full workup (especially given that she would need to be fully sedated, which carries risks). He let me draw her blood to recheck her lactate level (which was one of her abnormal results yesterday), and it was normal. He also gave her a cerenia injection. He said if she vomits on the cerenia, then she must be brought back in. So we are just hoping that does the trick.

He said cerenia can take about an hour to work, so I'm wondering when I should try feeding her? She is definitely hungry. She had the injection about 40 min ago.

He also suggested giving her 1.5 of Lantus tonight as long as she is eating, and even giving her 1 unit if she is not eating (as long as her BG is above 250).

So grateful for all the support from this group. It helps me feel so empowered!
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I hope the Cerenia injection does the job for Vesper (btw, I love that name). Glad the lactate level was normal--and I'm glad he rechecked it because...sometimes tests aren't accurate. Did he have an idea why she is vomiting??
 
Marielle said:
I hope the Cerenia injection does the job for Vesper (btw, I love that name). Glad the lactate level was normal--and I'm glad he rechecked it because...sometimes tests aren't accurate. Did he have an idea why she is vomiting??
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Thank you! I'm glad we rechecked it too. He said it could possibly be gastrointestinal upset from the antibiotics course she just finished, a pancreatitis flare, or just some other cause of acute gastritis. But he said the treatment is the same--the anti-nausea. He knew how important it was to keep her eating given her DKA history.

And the name is from James Bond :)
 
Kelly and Vesper said:
Thank you! I'm glad we rechecked it too. He said it could possibly be gastrointestinal upset from the antibiotics course she just finished, a pancreatitis flare, or just some other cause of acute gastritis. But he said the treatment is the same--the anti-nausea. He knew how important it was to keep her eating given her DKA history.
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Excellent! I love it when the universe sends you to the right person to find a fix to a problem. Give Vesper some feel-better-scritches from Jude and me.
 
Marielle said:
Excellent! I love it when the universe sends you to the right person to find a fix to a problem. Give Vesper some feel-better-scritches from Jude and me.
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Yes, he was the right person! He is the first vet who let me handle her myself. Every other vet has been worried about liability and wouldn't even let me pet her to calm her. The fact that he let me go into a private room and draw blood myself rather than risk sedating her totally won me over.

I will! Jude is so beautiful.
 
I'm just catching up. What an experience :bighug:. Glad you're back home. Try feeding little tsps of food to hopefully avoid any further tummy upsets.
You said Vesper is on an antibiotic. Sometimes antibiotics can upset the stomach flora. Are you also giving a probiotic to help with that?
As far as dose, I'd keep the 1.25 units since you just raised it this morning.
How's the home testing going? I read on your previous thread that Vesper can be a bit "spicy".
Tagging @Bron and Sheba (GA) for confirmation.
 
I like the sound of that vet!
And I’m glad you got the cerenia injection. I would wait the hour before trying to feed and then try small meals more frequently.
With the dose I think I would stay with the 1.25 U
Post at shot time if concerned and unsure. How long til shottime ?
 
Just to add you can also give ondansetron at the same time as the cerenia as they work on different pathways on that body. If she keeps the food down I would suggest a dose of ondansetron as well. That way you are covering more bases. Ondansetron can be given up to 4 times a day.
I see Angela posted with good advice as well:)
 
Angela & Cleo said:
I'm just catching up. What an experience :bighug:. Glad you're back home. Try feeding little tsps of food to hopefully avoid any further tummy upsets.
You said Vesper is on an antibiotic. Sometimes antibiotics can upset the stomach flora. Are you also giving a probiotic to help with that?
As far as dose, I'd keep the 1.25 units since you just raised it this morning.
How's the home testing going? I read on your previous thread that Vesper can be a bit "spicy".
Tagging @Bron and Sheba (GA) for confirmation.
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She finished her antibiotic yesterday morning, and I was giving her FortiFlora. I was later told that's not the best probiotic, but it actually worked wonders as an appetite stimulant and it's the only way I could get her to take her other pills (I rolled the pill pocket in it).

Her appetite is not quite back yet at home. She licked the gravy off her food but didn't eat the meat. I gave her a hydracare pouch and she ate some of that. I'm hoping she will feel better with a little more time, and maybe I'll try some FortiFlora on the food to entice her.

I think I'm getting the hang of home testing. Yes, Vesper is VERY spicy. Unfortunately, I don't think that will ever change. Although she is food motivated and likes treats, she has never liked being handled for any medical purpose. After 13.5 years, I'm still the only person who can cut her nails, and only my husband and I have been able to do her insulin shots. Even the vets cannot get her blood 50% of the time when she is on a full dose of gabapentin. She's the most affectionate cat ever, but only on her terms. Nevertheless, I am starting to feel more confident with using the lancet and knowing where to poke. She growls and spits and tries to scratch/bite, but if I'm efficient, I can get it done.
 
Bron and Sheba (GA) said:
I like the sound of that vet!
And I’m glad you got the cerenia injection. I would wait the hour before trying to feed and then try small meals more frequently.
With the dose I think I would stay with the 1.25 U
Post at shot time if concerned and unsure. How long til shottime ?
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Ok, will do! Shot time is in 3h.
 
If she won’t eat her normal low carb food, give her whatever she will eat at the moment. Eating is more important than what she eats at present. We need to get her over this hump.
You are doing everything right.
 
Update: PMPS is 495. She won't eat food but will drink a little hydracare and eat some freeze dried chicken. Should we do the 1.25?

Should we apply some miratz tonight?
 
Kelly and Vesper said:
Update: PMPS is 495. She won't eat food but will drink a little hydracare and eat some freeze dried chicken. Should we do the 1.25?

Should we apply some miratz tonight?
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If you can monitor I would give the 1.25u. The onset will not be for 2 hours and hopefully she will eat. Let her eat anything.
Has she eaten much since you got home. ?
And yes I would apply the mirtaz
I’ll be around for the next 8 hours so tag me if you need help
 
Bron and Sheba (GA) said:
If you can monitor I would give the 1.25u. The onset will not be for 2 hours and hopefully she will eat. Let her eat anything.
Has she eaten much since you got home. ?
And yes I would apply the mirtaz
I’ll be around for the next 8 hours so tag me if you need help
Click to expand...

Okay we gave her 1.25u. She ate about 1/2 cup of freeze dried chicken and drank 1.5 packets of the Hydracare. We put a few different food options out for her and will see if she eats in the next few hours. We will apply the miratz now too. We'll check her periodically through the night and post if we have questions. Thank you again, we are so grateful.
 
Kelly and Vesper said:
Okay we gave her 1.25u. She ate about 1/2 cup of freeze dried chicken and drank 1.5 packets of the Hydracare. We put a few different food options out for her and will see if she eats in the next few hours. We will apply the miratz now too. We'll check her periodically through the night and post if we have questions. Thank you again, we are so grateful.
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Hang in there, Kelly and Vesper!
 
Vesper is showing zero interest in food or treats. I'm hesitant to try the chicken treats again because I just realized they are freeze dried raw, and I'm worried about bird flu. She also just had some pretty bad diarrhea (some soft stools and then a lot of liquid). Hoping the meds help her soon.
 
+3 is 359. I'll check again in a couple hours. She ate a few kernals of dry food (science diet oral care and science diet kitten kibble). Really hoping she eats more soon.
 
Kelly and Vesper said:
Vesper is showing zero interest in food or treats. I'm hesitant to try the chicken treats again because I just realized they are freeze dried raw, and I'm worried about bird flu. She also just had some pretty bad diarrhea (some soft stools and then a lot of liquid). Hoping the meds help her soon.
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Will she eat any of her old foods?
 
Bron and Sheba (GA) said:
Will she eat any of her old foods?
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The dry food is the only thing she's showing a (very slight) interest in. I know it's not ideal, but I'm offering it to her just to give her all possibilities. She eats a few bites and then shows no interest again. I'm hoping the appetite stimulant will help soon.

I'm wondering if the hydracare could have caused the diarrhea or if the diarrhea is part of the underlying problem causing all of this. If it continues, I guess we will have to take her back to the vet tomorrow for fluids.
 
Kelly and Vesper said:
The dry food is the only thing she's showing a (very slight) interest in. I know it's not ideal, but I'm offering it to her just to give her all possibilities. She eats a few bites and then shows no interest again. I'm hoping the appetite stimulant will help soon.

I'm wondering if the hydracare could have caused the diarrhea or if the diarrhea is part of the underlying problem causing all of this. If it continues, I guess we will have to take her back to the vet tomorrow for fluids.
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I would let her eat the dry food if that is what she wants at the moment. Don’t worry if it’s higher carb. That’s the least of your worries and can be sorted out when she feels better. The more pressing problem is her eating
It’s hard to know what is causing that diarrhoea. Yes if it continues tomorrow I would take her in for some iv fluids.
 
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