9/4 - Vomiting -- shoot with insulin?

Status
Not open for further replies.
Re: 9/4 - Please help with newly diagnosed cat

I haven't shot yet. I just tracked him down in the basement puking up about half of what I just fed him.
Is it still safe to give him the insulin? 1 unit?
 
Re: 9/4 - Please help with newly diagnosed cat

ugh, he's vomiting? that might change things. would you edit your first post of this thread on page 1 and say "baby vomiting, shoot insulin?" for sienne to see it, please?
 
Re: 9/4 - Please help with newly diagnosed cat

I'm really concerned about him not eating. Something is going on here. I hate to say it....maybe visit to the EC tonight?
 
I can't afford the emergency vet clinic. I'm tapped out.

I'm assuming he is puking because I overfed him given he did not puke otherwise today. But I don't really know.
 
no possibility of getting him to the ER? if he weren't diabetic it would be serious, but not AS serious. but the combination of not eating and diabetes is very serious.

can you phone the vet and talk to someone?
 
Clearly not eating is scary, and vomiting is not a good addition. But, if D chooses not to go the Emergency route, what dose would you all suggest?

There seems to be something of an active debate over how much insulin a "fasting" cat needs. There is still glucose sources from the liver that need help being used by the rest of the body, but clearly there is much less coming from food.
 
She said earlier that the pharmacy was not open when she went out, so I don't think she has sticks. She has also not mentioned any testing, so I don't think we have that data.

We are fighting hepatic lipidosis here with fat breakdown being used as the primary energy source, but given how high the BG is, there is also some glucose around to be used if there is insulin to mediate that metabolic pathway. We don't want HL and DKA at the same time.
 
i don't know if all these ideas have been mentioned, but here's a good list of appetite enhancers from cheryl/winnie:

http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=26965#p273790
Remember -- getting to the bottom of why he is not eating is most important. That way you can treat the underlying cause ( or symptoms of underlying cause) . It is always very important to get cats to eat, as they can quickly develop hepatic lipidosis from lack of food.

Here are some things you can do do entice your cat to eat:

-sometimes in order to get a cat to eat you even have to resort to dry it is more important that they eat. there are a couple low carb / grain free brands -- EVO and wellness core.

-making a buffet to give him choices
- heating food

sprinkle food with :
- forta flora -- a probiotic you can get at vets or online. is very smelly and cats love the taste of it.
- parm. cheese
- smashed crumbles of dry food
- bonito tuna flakes
- halo chicken treats -- crumble into dust over food -- my Wolfie loves this stuff.
- poor a little water from tuna in water over food ( I use low sodium/no sodium added as other kinds in water has veg. broth in it and I assume that means onions, which are toxic to cats-- check labels)
-powdered oregano. yep sounds weird . but some cats like it and it will entice them to eat.

other ideas of foods to offer your kitty to stim appy:
- trader joe tuna for cats
-baby food -- beechnut turkey and broth or chicken and broth. they have no onions or other additives. some babyfoods have onions . please read labels if you can't find beechnut.
- kentucky fried chicken
- deli turkey /chicken
- plain cooked ( boiled or baked ) chicken breast
-canned chicken for people (watch the label that their are no onions)
- chicken broth -- low sodium

If enticements don't work, you should consider:
-assist feeding ( syringe or make little meatballs and place in mouth)
-and/or talking to your vet about appetite stimulents ( mirtazapine or cyproheptidine)

and if those fail talking to your vet about feeding tubes
- Here is Dr. Lisa's link on feeding tubes :

http://www.catinfo.org/?link=feedingtubes
 
Sam and S'mores said:
We are fighting hepatic lipidosis here with fat breakdown being used as the primary energy source, but given how high the BG is, there is also some glucose around to be used if there is insulin to mediate that metabolic pathway. We don't want HL and DKA at the same time.
Click to expand...
yes, sam. how about if we slow down and take one step at a time...
getting kitty to eat, giving plenty of water, and testing for ketones is the first step in lieu of an ER visit tonight.
 
I really don't know what to do. He is actually feeling really good after the puke -- jumping up on his hind legs for petting and really interacting with us. Energetic, almost.

I don't understand why he ate fine until the first day he had the insulin.
 
I'm sure there is a 24-hour pharmacy somewhere, but what is the benefit of testing for ketones if I can't take him to the vet right now? I really don't know.
 
D & Baby said:
I don't understand why he ate fine until the first day he had the insulin.
Click to expand...
it could be for any number of reasons. throwing ketones would be my first guess.

when alex was diagnosed we went through a very similar scenario. ketones can develop in a matter of hours. alex didn't appear to be throwing them at the vet's office (vet checked urine, not blood). by the next morning, alex was in full blown diabetic ketoacidosis.
 
D & Baby said:
I'm sure there is a 24-hour pharmacy somewhere, but what is the benefit of testing for ketones if I can't take him to the vet right now? I really don't know.
Click to expand...
if kitty is throwing ketones, you might be able to get away with syringing water and food throughout the night... depending on the level of ketones he might be throwing. if it's a moderate to large amount he really should be under a vet's care asap.
 
ps ----- and that's "if" he's throwing ketones.

being able to test his urine for ketones will help rule out or confirm one *possible* problem.
 
how many hours ago was the last shot given?

what was the dose administered?

we need to get some insulin into kitty. are you comfortable syringe feeding if necessary tonight?
 
I haven't given him the shot, because I didn't know if I should after the puking.
At this point, given his numbers are going up, I'm thinking I should go ahead with the 1 unit.
I can't tell you how good he seems to suddenly feel after throwing up and while I have no doubt it could be very serious, and I'm sure you all know better than I do given your experience here, isn't it possible he was just too full and I made him feel nauseous by forcing him to eat? I had this experience with his littermate who had cancer and a feeding tube, so it makes me wonder. He hasn't been throwing up all day - just tonight after he pretty much indicated he was done eating and I gave him maybe one syringeful too many.

Last shot was 8:15 this morning. I'm obviously overdue. Just did not know what to do.

I can syringe feed tonight to a degree. I've been doing it all day, so it's not like he hasn't eaten all day.
 
I expect Jill to suggest giving the shot, presumably at 1u, but I'll let her chime in.

On the food side, we are all still concerned because the amount of food you got in is still a small fraction of what he should be eating today. 5.5oz refers to the cat food, which has more energy than the baby food per ounce. 5.5oz cat food is ~200kcals. Karrie's post suggested 2 baby jars is equivalent, but only the larger 100kcal jars. You were able to get in maybe 75kcals from baby food (minus vomit) and maybe another 50kcals from the tuna. It's a good start, but it's not enough yet.

Overnight, you are still trying to get as much food and water in as possible, so leave out what you think he will eat. Fasting causes Feline Hepatic Lipidosis where the body basically poisons itself while trying to use stored fat as the primary food source. The treatment is force feeding, and the prefered food for treatment there is also high-protein, low carb.

With the high BGs, we are also worried about Feline Diabetic Ketoacidosis (DKA), which is where there is not enough insulin to help the body use the glucose it has, plus some added stress kicks the system over the edge. In this case, we are taking about the standard Diabetes treatement (insulin and low-carb food), but you also want as much water as possible to flush the ketones, and the ER would work to get the various electrolyte levels back in balance as well. In emergencies, this means IVs and sub-Q fluids (I know first hand b/c that's what we went through with S'mores)

Because we are worried about both, I don't think you want to go to a high-carb food to entice Baby to eat. Put out his favorite FF, maybe with some extra water to keep it moist.
 
sorry. my internet went down.

first things, first. if he has ketones and you absolutely can't go the ER, you'll want to syringe water every hour or two all night long.

food can be syringed every 2 - 3 hours.

i really, really do think you need to get at least 1 unit of lantus into him as soon as possible. next shot will be due in 12 hours.
you will need to monitor his blood glucose.

obviously, the best thing to do is to go to an ER. i'm just trying to lay out an alternate plan if an ER is totally out of the question.

yes, it's a lot of work. i'd try to cat nap when i could and use an alarm clock to wake you up.



ps--------- fyi everybody: my internet *could* go out again.
 
OK D, so after you give the shot, if you can find somewhere to get Ketone sticks, it could make all the difference. Fingers and toes crossed that it comes back negative, and we are just worried about the food issues. If it is possitive, then we are in for a fight.
 
Sam and S'mores said:
Because we are worried about both, I don't think you want to go to a high-carb food to entice Baby to eat. Put out his favorite FF, maybe with some extra water to keep it moist.
Click to expand...

Sam gave you some good advice. However, in a case like this... give Baby whatever he'll eat. He has to eat. When Alex isn't eating over a prolonged period of time I'd make her a heaping plate of pasta if that's what it took to get her to eat.
 
The Ketone sticks are usually NOT behind the pharmacy counter, so if you find a drugstore that is open, you should be able to pick them up off of the shelf even if the pharmacy part is closed.
 
The shot is done. 1 unit.

I'll do what I can in regards to water and food tonight.

I sincerely appreciate all of you taking the time to help me with this. I can't even articulate it right now beyond a standard thank you but it really should be so much more.

I will report back later if anyone is online.
 
good luck. i know it's not easy to nurse a cat all through the night. i've been doing it myself the last two nights and i'm beyond exhausted.
please get those ketostix asap, ok?
 
there are several of us looking out for you and Baby tonight. it's hard enough to go through without going through it alone. i'm in oregon and can stay up with you if you want - i'd be up at least another hour anyway.

what would be most helpful to you? do you feel like you understand what to do and have a plan? or would you like to get the ketone test in (btw, they're on the shelf by the test strips) and report back on it?
 
D --

It's a lot to handle. Jill probably knows this more than most -- she's nursed her Alex through a lot.

If there's someone who you could coax into picking up Ketostix tonight, that would be great. Do you know if Baby would eat high carb food? I think you mentioned something yesterday about Baby licking the gravy off of food. Most cats love the high carb canned foods. At this point, since eating is the important issue, it might not hurt to crack open one of the cans of HC you bought and see if it will interest Baby.
 
aly, she did give insulin tonight.

D - i'm going to head for bed. if you need help, post here and post on the Main Health forum too if you don't get an answer. with people all around the world, there's often someone on one place or another.

thinking about you tonight - after a sick kid last night and nursing Baby all day, i know you're exhausted. a lot of us sleep and set a cell phone alarm to wake up in time to recheck our kitties when they are sick.

hugs!

btw, if you have a spare ounce of energy, take off the 911 from your first post of the first page of this thread. otherwise every person getting on all night long will be checking to see what the crisis is.
 
I think syringing cat food is the best option also over babyfood. The babyfood that is 100 calories a jar is Gerber and it has corn starch. Your cat sounds like he can handle syringe feeding so focus on using a syringe. Warm up the food and add some warm water. Wet food is 80-90% water so don't add too much liquid. Enough that its easy to syringe feed.

I think your cat does need a vet visit and anti nausea medication (ondansetron or dolasetron) - Cerenia can be used for vomiting but may not handle general nausea. Maybe there is pancreatitis or FHL going on. So get them labs on Tuesday, keep testing for ketones. Focus on calories and water to avoid DKA. You have the diabetes pros all here helping you and guiding you.

I focus on the assist feeding side so that cat's don't have to battle FHL on top of diabetes. I am not a diabetes expert but I'm learning a ton about DKA the past two weeks with Garland and her feeding tube.
 
Good morning!

In all the excitement yesterday, I forgot something... YOU ROCK!!!!! 5 successful syringe feedings, and 13 or 14 BG measurements! WOW, that's a day!

I second the medication suggestion. When we got S'mores, he was not eating, and a little bit of whatever the vet prescribed made an immediate impact.
 
Just a reminder - do not go with an appetite stimulant - it will compound the problem and make a cat with nausea and inappetance feel worse. Appetite stimulants should only be used when a cat is eating but not enough and when you are 100% sure nausea is addressed.

Anti nausea medication is worth its weight in gold for many cats. But you need to syringe feed until you find the underlying cause of the inappetance.
 
If the vomiting was a one time thing due to what D thinks (i.e., over feeding), the anti-emetics may not be necessary. We'll be able to tell today. If this is the case and Baby still isn't eating well, an appetite stimulant (mirtazepine or cyproheptadine) may help.

D - if you see this, please start a new condo (thread) for Monday.
 
Nausea isn't just vomiting though. We know cats with FHL are terribly nauseated and shouldn't be given an appetite stimulant until nausea has been addressed. Same with pancreatitis. Appetite stimulants should be used on a cat that is already eating some on their own and when an owner is sure nausea isn't an issue. I like to compare it to giving a human with the flu an appetite stimulant. It may make you eat the chicken soup but you'll be even more miserable and most likely will never eat chicken soup ever again.
 
Status
Not open for further replies.
Back
Top