9/4 - Vomiting -- shoot with insulin?

Status
Not open for further replies.
D

D & Baby

Member Since 2011
I can't seem to get a spreadsheet created at this time, so please bear with me. Posters on the main board suggested I post here.

Long story short, my cat had his first curve Friday at the vet. His numbers were in the 300s. I gave him his first shot of 2 units at 8:30ish Friday night after getting him to eat about half a can of food. Saturday morning, he had little interest in food. I took his blood and he was at 112. I consulted the main board here and came to the conclusion it was best not to give him a shot. He didn't want to eat all day. I got him to eat a slice and a half of deli turkey at night, but since he still had low numbers (136), I decided not to give him insulin again. Later, around 10:30 he ate a quarter can of tuna and a few bites of 9 Lives flaked tuna cat food, and again at 1 am with about a quarter can of tuna and maybe one bite of the cat food.

These were his numbers throughout the day:
8:45 - 112
9:15 - 182
9:20 - 127
10:15 - 118
6:45 - 136
8:15 - 186

Today:
6:25 - 310

So I'm assuming I should get him to eat as much as I can (I'm assuming I can get him to eat the quarter can of tuna, if nothing else) and give him a shot? Consensus on the other thread was to try 1 unit only. He weighs just under 13 pounds (and was closer to 17 or 18 pre-diabetes).

Thoughts or opinions desperately needed.

Thanks!
 
Re: 9/4 - Please help with newly diagnosed cat

Hi D,

I'm really concerned about him not eating. When did that start?
When was he diagnosed for FD?
Have you checked his urine for the presence of ketones?
 
Re: 9/4 - Please help with newly diagnosed cat

Welcome, D, to the Lantus board.

Here's the link to your thread (we call them condos) from Health.

If you are feeding human tuna, it's good that you're getting food into Baby. However, human food does not contain all the the nutrients necessary for a cat's health (e.g., taurine). We'll do what we can to help you get Baby back on her food -- that's critical.

If you are going to run out for food (you mentioned it on Health), could you also pick up some Ketostix? If Baby isn't eating and numbers are now up after 24 hrs without insulin, we want to encourage you to be proactive and make sure ketones don't become a problem. Also, if you're heading out to a grocery store, could you pick up some baby food? Gerber Stage 2 or Beechnut varieties that contain ONLY meat and broth (no onions, garlic, veggies) are recommended. (The Gerber contains cornstarch.) Many cats really like baby food. It may prime the pump and get Baby started eating.

Has Baby ever had a dental? Among the reasons a cat may not want to eat is if there's a dental problem. A broken tooth or resorptive lesions can be quite painful.

I do think you need to give a shot this morning. I would probably go with the 1.0u. It is important, though, that Baby eats.
 
Re: 9/4 - Please help with newly diagnosed cat

Sandy - He was eating fine Thursday. Went to the vet Friday for his first curve and would not eat there (understandable) and then had no appetite at home although I got him to eat some canned cat food. Yesterday he ate very little and today he is acting less tired but when I put regular food on the plate, he walked away. I tried tuna juice on it and he licked wherever the juice ran. Added tuna mixed in and he picks through the food pulling tuna out. So then I gave him straight tuna because I figured it was better than nothing at this point.

He ate a little more than a quarter can, so I am about to give him a reduced shot -- 1 unit or less -- and I'll test him throughout the day. In hindsight, I'm wondering if his blood sugar went very low overnight after I gave him the shot Friday night and it made him feel crummy. I did not test until Saturday morning when he didn't want to eat but was due for his first shot of the day.
 
Re: 9/4 - Please help with newly diagnosed cat

Sienne - He has not had a dental.

He was fine Thursday, at the vet all day Friday for the curve and came home not wanting to eat.

If the pharmacy is open, I can get the sticks. If not, I'm kind of out of luck because my husband needs to work (not usual for him on a Sunday) and I will need to be home to monitor the cat.

Now that he's eaten, I'm going to give the shot and then head out the door so I can get back in time to test his blood 1 hour after the shot.
 
Re: 9/4 - Please help with newly diagnosed cat

I'm happy to hear you are going with 1u, that's probably what I would have done.
 
Re: 9/4 - Please help with newly diagnosed cat

I've got a dumb question for you... Do you happen to know if they fed him at the vet's office and if they fed Baby, what they fed him? It just seems so odd that he'd have developed a food aversion and be feeling OK.

Just so you don't feel like we're harping on the food issue, eating trumps a lot of other problems. A cat that's not eating can develop a host of serious medical problems. I'm going to see if Karrie/Maverick will stop by. She's extremely knowledgeable about hepatic lipidosis and how many calories per day are needed to prevent the development of HL, which can develop if a cat's not eating.
 
Re: 9/4 - Please help with newly diagnosed cat

Back from the store. I got the baby food and some high carb food as well. The pharmacy was not open -- it's just 9 am here now.

The vet said they gave him food but he wouldn't eat. I don't know what they gave him, but I assume some kind of wet food. When we got home he did eat some food, but I had to kind of coax him. I figured it was just general weird feeling after being at the vet all day. I hope he's not now turning his nose up at the regular cat food because he thinks if he holds out he can get tuna or turkey.
 
Re: 9/4 - Please help with newly diagnosed cat

you've got the best possible help here. i just want to give you a little encouragement! :YMHUG:
 
Re: 9/4 - Please help with newly diagnosed cat

Cats can stop eating for so many reasons. A big non illness related cause is stress. A visit to the vet for him may have been extra stressful.

What foods was he eating before the vet?

Did you get blood work done when he was diagnosed - can you pick up a copy? That is a lot of weight to lose and I'd like to see his other numbers.

It is very good that you noticed he isn't eating. As Sienne noted you do not want to deal with feline hepatic lipidosis on top of diabetes. FHL happens when a cat doesn't eat enough and they use body fat for energy. A cat's liver doesn't process body fat like ours do and it can clog up with fat very quickly causing liver failure. So its important that you start assist feeding right away if you can't tempt him to eat.

There is a great site on Yahoo - Feline Assisted Feeding. When you join the Yahoo group you get sent five auto files. One of them is how to safely assist feed via syringe. Baby food is perfect for syringe feeding. The reason for starting right away is to keep that liver healthy until they get ready to eat on their own and to diagnose what else is going on if its not psychological. You can pick up syringes at your vet or at the pharmacy or the bird section of the pet store. When you assist feed the goal is a 5.5oz can of food a day as a guideline. Or two jars of the baby food if they are 100 calorie jars. Every cat is different though. We highly recommend an accurate scale for knowing if your cat is eating enough.

Do you know someone with a baby scale you can borrow? You can buy scales cheaply on amazon - shipping/baby/pet scales sometimes as low as $20 with free shipping. Make sure it weighs to the ounce if you buy one. Our baby scale actually caught Maverick's diabetes extremely early. before any other symptoms showed up just weighing him monthly. It caught a weight loss that wasn't normal for him.

As Sienne stated some cats just need their pump primed. A couple mouthfuls of food - even finger fed and they will start feeding on their own. Some people can finger feed their cats - putting dollops of food from your finger into their mouths.
 
Re: 9/4 - Please help with newly diagnosed cat

Before he was diagnosed, he ate Purina One dry and 9 Lives Flaked tuna wet.

After diagnosis, we switched to high protein/low carb wet food exclusively. We tried a variety of types from the natural pet food store to see what he would eat/like best and he didn't hold them down very well. He was on Clavamox at the time, so I think that affected his appetite. He finished the Clavamox and then was throwing up a bit here and there but still had an appetite and was eating regularly. The vet saw him, said infection was gone and he was fine except for the diabetes and thought maybe all the different foods were doing a number on him. He hadn't lost weigh, or if he had, it was negligible.

I ended up buying some Fancy Feast from a list here and he did better on that and I re-introduced the 9 Lives since it is on the list and he stopped throwing up altogether -- literally the day after the vet visit. And then it was about two weeks before we could schedule the initial curve at the vet's office, get the lantus, etc. (Forgive me for not knowing specifics as I am also dealing with/managing a chronic condition my son has which flared during this time so my priorities were elsewhere and the vet's office is not as well-managed as it could be, but we love the vet herself so we just deal with it.) But he ate normally during that time. Admittedly, this is a new normal, given that we used to free feed dry food along with a once a day wet food feeding, so I have been going on my gut feeling that he was eating enough. He certainly had an appetite and was asking for food.

Sorry for the novel, but I think I answered all the questions.

Oh, except the bloodwork -- yes, they did some blood work. I don't have copies and the vet is closed until Tuesday. I am guestimating on his weight pre-diagnosis. He has weighed close to 19 pounds and was too heavy at that weight, but not a huge fat cat. I think 17ish is a more normal weight for him. At his current weight, I can feel his bones.

I don't have a baby scale. I do have a digital scale that weighs to the tenth of a pound. I also have a kitchen scale for weighing flour, so I could weigh how much food I'm giving him and how much he actually eats.
 
Re: 9/4 - Please help with newly diagnosed cat

Definitely get the blood work. That is a lot of weight and I'm concerned that his liver was affected already.

It is important that you get calories into him and that he keeps them down. The human scale isn't accurate enough but is better than nothing. Start weighing him daily - maybe add it to the notes section of the spreadsheet.

Unwell cats often need more calories to maintain their weight than a healthy cat without issues. I would go for maximum calories vs "enough". So if you can syringe feed more than two jars of babyfood that would be helpful. Most cats should be able to handle 30cc/30ml feedings per feeding and every three hours. The stomach should empty by the two hour mark. Wishing you only have to assist feed for a few days but he needs your help until he's eating enough on his own. You may have to supplement what he does eat so do monitor how much he eats on his own also.

You can syringe feed wet food also. If he was vomiting before I wonder if he had/has a pancreatitis flareup. Food with higher fat aren't tolerated well. But pancreatitis often causes nausea. So watch for signs of nausea. In cats this shows up not only as vomiting, but also showing interest in food but licking or sniffing and walking away, lip licking/smacking, and teeth grinding. If a cat throws up food an hour or more after eating, stomach motility may be an issue. If he throws up clear vomit stomach acid could be a problem.

Can you keep us posted on how the assisted feeding goes? If he still vomits we can recommend some things to ask the vet for. He needs a few good days of lots of calories, maybe longer. Lets see what the blood work shows also. I have an efax number if its far for you to drive.

Any sitting like a sphynx or meatloaf?
 
Re: 9/4 - Please help with newly diagnosed cat

It was a bladder or urinary tract infection that required the Clavamox.

I guess I'm going to try feeding him some baby food via syringe. He just ate some turkey, but only .1 oz. And a few bites of tuna earlier (after his shot) but I did not weigh it to see how much. And, of course, the tuna I gave him before his shot, which I'm estimating as 1.2 oz. So my guesstimate for today's food intake so far is 1.5 oz. of food.

He has not been throwing up since two weeks ago when the vet thought it was the food mixture. He does express interest in food but when I put down cat food, he turns away. When I give him a treat like tuna or turkey, he will eat. Just not enough, I guess. No lip smacking or teeth grinding that I've noticed.

Sphinx sitting? No more than normal, I guess. At least I haven't noticed it. Mostly he is laying around. I'm not sure what meatloaf sitting is...?
 
Re: 9/4 - Please help with newly diagnosed cat

I just fed him 21 mL chicken baby food via syringe. I didn't want to go overboard in case it made him feel like throwing up. He actually seemed to like the food. I'll try giving him more in a few hours. Should I water down some canned food and give him that instead/as well, given he needs nutrients not found in ground chicken or turkey? Or should I just try to get through the day (next few days) with whatever works best, making sure he has food in his belly?

I guess my question re: feeding and the insulin is really how does that type of feeding work with the insulin? I'll try to get as much food into him as possible, but do I need to stop a couple hours before his shot is due so that I can test without any recent food in his system?

I gave him a half-dose based on yesterday's low numbers and they are in the 300s again today. So, do I give him a full dose, half dose or somewhere in between tonight since he will hopefully have more food in his system?
 
Re: 9/4 - Please help with newly diagnosed cat

I think meatloafing is when they sit on all their paws
willow-meatloaf.jpg
with their head kind of pointing down and they look like they're depressed or they have a tummy ache.
 
Re: 9/4 - Please help with newly diagnosed cat

Syringe feeding the canned food you want him to eat is generally the best option if you can. It gets the cat used to that food, and as you say, it is nutritionally complete for the cat.

Post the numbers today (SS?), and we can help tonight, but in general the default should be 2 or 1.75u full dose if the numbers stay reasonable today. Assuming you are able to get enough food into him, it would be great to hold off for the last 2hr before the shot, but as everyone here has said, getting enough food in is the first priority.
 
Re: 9/4 - Please help with newly diagnosed cat

I will try to create a spreadsheet later. The online Google doc won't work for me. I found the alternate way of creating one, but I am not on my own computer right now and cannot download anything.

His numbers are in the 300s all day, so, pretty high compared to yesterday.
 
Re: 9/4 - Please help with newly diagnosed cat

Great. High today is not too much of a surprise given the long break with no shots, and the small shot this morning. It can take a few ***** before the full effect of the Lantus kicks in. You do need to decide what you think the full dose is, but given your success with syringe feeding, you should be able to deal with any low numbers by feeding HC or syrup, so we are in a much better place than yesterday.
 
Re: 9/4 - Please help with newly diagnosed cat

both the baby food and cat food are ok to feed him - pretty much you just need him to eat at this point.

it's a good idea to test maybe 30 minutes before your shot time, then post that number with a request for dose advice. often it's hard to suggest a dose much before shot time, because so much depends on how the cat is feeling at shot time - if he's eaten, especially.

what time is shot time and what time zone?
 
Re: 9/4 - Please help with newly diagnosed cat

It actually takes more than a few "doses" (much safer word given Sam's malapropism) for Lantus to start doing it's work. It takes 5 - 7 days for an insulin depot or "shed" to form. Not all of the insulin you are giving will be available to work on bringing blood glucose levels down.

On the other hand, Baby was getting a response on 2.0u whereby her numbers were too low for you to shoot which does suggest that the dose may be too high.
 
Re: 9/4 - Please help with newly diagnosed cat

I'd blame the phone, but I think I posted that from a real computer... ohmygod_smile
 
Re: 9/4 - Please help with newly diagnosed cat

:-D

I have so far gotten 2.5 oz. of chicken baby food down the hatch via syringe. (And may I just say -- yee-uck! -- I don't know how people feed that to human children!) So, combined with what I estimate as 1.5 oz. of tuna and turkey earlier, we're at 4 oz. of food for the day.

I gave him a shot at 8:15 this morning, so I'm aiming for 8 pm tonight, as I need to get him back to a 7am/7pm schedule due to my work schedule. That gives me two hours to get 1.5 oz. to equal the 5.5 oz noted below in order to have a two hour food-free window before before I shoot. I'm aiming for one more jar.

Unfortunately, the baby food jars I have are 50 calories each, so he's only had 50 calories from that. Fortunately, though, he is not throwing anything up, so at least there is that.

So I'll be posting here around 7:45 PT -- I'm in Washington State. If anyone will be around to offer advice, I will really appreciate it!
 
Re: 9/4 - Please help with newly diagnosed cat

Sienne and Gabby said:
It actually takes more than a few "doses" (much safer word given Sam's malapropism) for Lantus to start doing it's work. It takes 5 - 7 days for an insulin depot or "shed" to form. Not all of the insulin you are giving will be available to work on bringing blood glucose levels down.

On the other hand, Baby was getting a response on 2.0u whereby her numbers were too low for you to shoot which does suggest that the dose may be too high.
Click to expand...

Does eating/not eating affect the numbers? i.e. Could the numbers have been so low after only two shots in part because he hadn't eaten much the day/night before? So, if he were to eat regularly, he might require the higher dose? Today with the 1.0u, he is in the 300s, high 200s all day. But he's had a lot more food to eat as well. I imagine it's quite a dance to get the numbers/food right.
 
Re: 9/4 - Please help with newly diagnosed cat

So, after I give the shot tonight, I'm assuming I still "assist" him with eating a few hours after that as well, to try to top him off? That will help the calories add up for the day.
 
Re: 9/4 - Please help with newly diagnosed cat

Food does effect numbers. The more food and the higher carb the food, the higher the BG numbers will be. Not eating can definitely cause numbers to be lower. The problem is, though, there's no way to know. If a cat's not eating (or not eating well) and you give insulin, numbers can also drop. The added problem of the cat not eating makes it difficult to then get the numbers to come up. We use high carb food or food + syrup (Karo, honey, etc.) to bring numbers up.

An additional reason for numbers to be up today is that you didn't give any insulin for 24 hours (yesterday AM to this morning) and having not given insulin for that period does have an effect on the shed. Since skipping doses does effect the shed, we typically suggest that you reduce the dose so you can comfortably shoot twice a day.
 
Re: 9/4 - Please help with newly diagnosed cat

I don't have any better advice than those who are already advising you but I just wanted to say welcome to Lantus Land. I've only be dealing with Smokey's diabetes for a little over 2 weeks and the people and kitties here have been GREAT! Hang in there- you are doing wonderful things for Baby!
 
Re: 9/4 - Please help with newly diagnosed cat

You are doing a great job and getting lots of good advice. Thanks everyone!

I do have a request/suggestion, given all the great feeding suggestions I've seen on this condo and others. Would someone be interested in summarizing in a sticky? We've had trouble getting Zener to eat (now he cries for food, but it's coming up on shot time :sad: ) and it would be nice to have these ideas all in one place. Just a thought...
Liz
 
Re: 9/4 - Please help with newly diagnosed cat

Sorry for no spreadsheet. As before, it will not work online and I am not on my own computer, therefore cannot download the document for the alternative way of creating it. I will work on it tomorrow. In the meantime, here is where I'm at.

BG:
6:25 - 310
--- 1.2 oz tuna
Shot: 8:15 am
9:15 - 377
10:20 - 336
---21 mL syringe feed
11:25 - 365
12:25 - 341
1:25 - 288
---21 mL syringe feed
2:25 - 275
3:25 - 330
---10 mL syringe feed
4:25 - 305
5:25 - 291
---21 mL syringe feed
6:25 - 339
7:25 - 333

So, I can syringe feed him again now before a shot, but I am unsure what to give him shot-wise.
Initial dose was 2 units. Yesterday his numbers were too low to give him a shot. (And he was not eating properly.)
Today I gave him 1 unit in the AM.

I can give him another syringe feed around 11 pm and then I am done until tomorrow.

Thoughts, suggestions on tonight's dose?

Thanks in advance!
 
Re: 9/4 - Please help with newly diagnosed cat

He's been pretty good with the syringe but not interested in eating it himself. So, I put the baby food jar under his nose, he sniffed it with interest but didn't even lick it. I syringed it into his mouth and he would sniff any that would fall to the ground during his open-mouth chewing, but wouldn't actually lick it up. This evening he wasn't as happy about eating it via syringe (as earlier he was just kind of, "whatever", later on he took a few syringe-fuls and wanted to walk away, but he did allow me to feed him a bit more than he really wanted.) I'm sure I'm stuffing him so he has no interest in eating on his own because his stomach is full. I don't know.

Editing to add - I last fed him after his 5:25 blood draw. But not as much as I could have, given I will need to feed now, before sticking him.
 
Re: 9/4 - Please help with newly diagnosed cat

What, exactly, are you syringe feeding him?

In any case: regarding dosing, you are getting food in, and so you can respond to low numbers. You want to get his BG down to a good range to help with appetite as well. You need to make your best estimate on what you think his "full" dose is and shoot that. From what I've seen, I would think that is either 1.5u or 1.75u, but I'm sure others will chime in.
 
Re: 9/4 - Please help with newly diagnosed cat

The only thing I've syringed is baby food. First chicken, then turkey. I still have half a turkey jar left -- most of which I will give him shortly, just before I give him his insulin.

I am leaning towards 1.5 -- conservative, I guess. But I can feed him around 11 and then I absolutely have to get some sleep. So I'm worried about giving him too much.
 
Re: 9/4 - Please help with newly diagnosed cat

Beech Nut chicken and chicken broth (finished one small jar) and Beech Nut turkey and turkey broth (half a jar left which I will feed before the shot).
 
Re: 9/4 - Please help with newly diagnosed cat

And prior to the baby food he ate some tuna (before his AM shot) and some turkey, although very little. Can't get him to eat any actual cat food.
 
Re: 9/4 - Please help with newly diagnosed cat

I am going to feed him now in anticipation of his shot. Hoping for more input before the needle comes out...
 
Re: 9/4 - Please help with newly diagnosed cat

i'm not one of the people who is super confident giving dose advice - especially with a sick kitty. but i know you're ready to shoot - i think i would stick with the 1 unit, just because i'd rather have him a little high for a couple of days til he's back eating normally than have him go too low and not be able to get him to eat.

i think you're safe with the 1 unit, but let's see if sienne, libby, jill or sandy is on, they have a lot more experience than me.
 
Re: 9/4 - Please help with newly diagnosed cat

I wish there were better people around to give you advice, but it looks like you are going to trust your own judgement. What feels right to you?
 
Re: 9/4 - Please help with newly diagnosed cat

i'm trying to get more eyes on this for you . . . sorry, i know you have a time crunch coming up. if you have to go ahead and can't wait, you'll have to just make a gut decision.

either way, i know you said you need to sleep, but probably Baby needs you to be monitoring him. i wouldn't feel comfortable not testing him - often people will set an alarm so they can test and go back to bed. if he were mine, i'd want to test at +2 or +3 and again at +5 or so - depending on the +2/3 numbers.
 
Re: 9/4 - Please help with newly diagnosed cat

Hi and welcome. I hope that your kitty will eat something soon. Generally, if a kitty is not eating, the insulin has nothing to work on. Therefore, I would agree that a smaller dose is best until you can get a handle on what is going on with her. It is safer to be in higher bg numbers than in lower numbers. I am not a dosing expert, but I would try the 1-unit dose tonight, because you should give some insulin. If Sienne, Jill, Libby, Laurie, or other experienced dosing people stop by to suggest a dose tonight, please follow their advice!

Ella & Rusty
 
Re: 9/4 - Please help with newly diagnosed cat

I could not get him to eat the entire remains of the jar -- so there is still a quarter of it left instead of half. He started really fighting me over it, which he didn't do earlier, and I don't want him to throw it up, so I'm stopping.

Given that I guess I'm left with 1 unit as a dose. I'm already past the time when I was hoping to give the shot.

It's not that I don't want to stay up and watch him, but I was up late last night monitoring him and then had a sick child up in the middle of the night -- and then I was up early with the cat again. I just don't think it's physically possible for me to stay up into the wee morning hours. So I guess I feel better about the 1 unit dose in that case.

Of course, now I have to track him down since he ran away from the forced feed. Sigh.
 
Re: 9/4 - Please help with newly diagnosed cat

I don't know if you shot already. I think I said earlier that I thought 1.0u made sense if you were having trouble getting food into your cat.
 
Re: 9/4 - Please help with newly diagnosed cat

Bless your heart. Your plate is so full right now and you are working so hard to help your kitty. Hugs for you and a big pat on the back.
 
Status
Not open for further replies.
Back
Top