Alex 7/23

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Ginny & Alex

Ginny & Alex

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Alex is still on his anti-b and I'm still shooting .8. Last night, a few hours after dinner, Alex threw up some of his dinner. It was a new flavor of Wellness (salmon and trout--yuck) that we'd never tried before. I don't know if it was the food (it was enough to make me vomit) or something else. As for his UTI, I still don't see any signs that he is having a problem. So other than the urine culture at the vet, that's the only indication he has one.

As you can see, he's flat today. I'm wondering if it's time for a dose increase.
 
Yup I'd say it is time to go up to a solid 1u. Just a tiny increase. Your mid cycle numbers aren't much lower than your preshots and you have pretty much been holding this 0.8u for a few days now.
 
Two days in a row, he's been lower at PMPS than at any other time of the day.
He's also in a funk--hiding under the sofa (no storms here, just hot) and not eating as much as normal. In fact, it's time to shoot, and he's showing no interest in his dinner.
 
I wonder if the antibiotic is messing with his stomach? Do you have any Forti Flora? All my cats go after that stuff like the kitty crack! I think I read somewhere it's like the stuff they spray on dry food to get the cats to like it so much?
 
I've never had any issues with him not wanting to eat, so no, I have none of the "appetite" enhancers. I even tried to give him some Evo dry food and he's not interested in that either.

If I delay the shot until he eats, do I delay the shot in the morning? And what about the anti-biotic? I think it should be given with food too.
 
I only ordered the Forti Flora cause my civvie wasn't eating...it worked! What is his BG? I think if he's not even eating the dry I would hold off, but I'm not an expert, just what I would do. Do you have any can tuna or chicken? Maybe baby food?
 
His BG is 194, the lowest it's been all day.
He threw up last night, but it was after a new flavor of food. I'm wondering if the anti-b is causing the problem. I started on Wednesday evening. I would have thought if it was going to make hms sick to his stomach, it would have started sooner, but I really don't know.
 
Guess I didn't really answer your question but I'm not really sure. When we have gotten off schedule I have adjusted in 1/2 hr increments but I also adjusted an hour & 1/2 before cause her BG was high. Someone else will have to answer that one for you!
 
Ginny & Alex said:
His BG is 194, the lowest it's been all day.
He threw up last night, but it was after a new flavor of food. I'm wondering if the anti-b is causing the problem. I started on Wednesday evening. I would have thought if it was going to make hms sick to his stomach, it would have started sooner, but I really don't know.
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I'm allergic to sulfa...I only had one pill left when I developed the problem, not sure if it might be the same sort of thing in a cat. Wish someone was nearby to give you some Forti Flora. I personally would hold off on both till you can get him to eat. Does he have a favorite "people" food? Thumper LOVES Boar's Head deli chicken breast...and I mean it has to be Boar's Head! :smile: Hopefully someone else will be on with better advice soon. His BG is not all that bad but you don't want it to get too high either.
 
Ginny, I would try to get him to eat something so you can at least shoot a reduced dose. Have you tried hand feeding him? Put a little on your fingers to see if you can get him started.

If you have some Pepcid AC, you can give him 1/4 of a pill in a pill pocket?
 
I called the vet that prescribed the clavamox and not surprising, the message said to call the ER. I called them and they said clavamox can cause nausea, but they wouldn't say whether to skip the clavamox dose or not. They need to see the patient first. If you recall, Alex doesn't "do trips".
 
Most people think that not eating plus not giving insulin can lead to DKA, which, of course, can be dangerous. Perhaps worst than skipping the insulin. I think the general thinking is that a lower than usual dose is better than no insulin. But getting him to eat something would be best.
 
They have a thread on I believe think tank that you should not skip a shot
if the cat is not eating..Please read, sorry I do not know how to cut and paste ...
they said you should reduce the dose.....
I am not an expert...I boil a checken breast and give that to Shakes to help with shots
All my cats love it, maybe you could try something like that..
 
yes it is think tank and here it is

sorry I dont know how to do the link thing

There is a strange meme that seems to have survived from the days of Humulin N, that I think is seriously endangering newcomers' kitties. The meme is
no food => no insulin.

I think this is just about as intelligent as
no exercise => no oxygen.

and for exactly the same reasons. When you exercise, you need MORE oxygen, but even when you're lying down you don't put a plastic bag over your mouth and nose and wait until you need to run around before you breathe again.

Insulin is needed every second of the day, just as oxygen is. What do you think the oxygen is doing? It's burning sugar in your cells for energy! What if there's no sugar there because some dunderhead advised to wait on the insulin?

A healthy pancreas is sending out about a 30% load of insulin even when you're fasting, because it's absolutely required to keep the brain and body functioning.

And if a cat stops eating, does their brain and body continue to function? So it needs insulin. Maybe a smaller dose, maybe not, depends how dramatically food affects the cat's needs.

But zero insulin is never called for in a new-diagnosed diabetic cat. Remember, their pancreas is suppressed from hyperglycemia and can't even produce that 30% at the moment.

Even worse, lack of insulin is the primary cause of DKA. And what are the secondary causes? Fasting, dehydration, and infection.

So no food + no insulin = asking for DKA.

Please all you happy advice givers, don't suggest waiting on the insulin just because kitty is reluctant to eat. On the contrary, that is likely to kill kitty. Suggest a slightly reduced dose. Biology doesn't work well on all-or-nothing solutions.Jock b.Oct 1996, Dx 25 August 2004,
The first Levemir Kitty! May 2005
Remission 05/2008 to 06/2008

* Lantus and Levemir: http://tinyurl.com/ydsnwlk
* Diabetic diet: http://tinyurl.com/6j2mj9d
* Everything else: http://petdiabetes.wikia.com/
 
I was planning to increase dose tonight, but given this development, I will stay at .8.
I'm thinking of skipping the Clavamox. Do you agree?
 
yes, I would skip the Clavamox but if you're gonna shoot I would reduce...I think that thread was saying by 1/2?
 
Hey Ginny.... I am on my phone and it is hard to "peck" on it... So short.. When Kitty had her vomiting episode that night her bg went low -- the culprit was the ab. Definitely skip the ab tonight! I would skip it tomorrow also ... And talk to the vet Mon.
 
Thanks, Kim. One good thing about the home vet is he has a pager that I can use. I wanted to talk to the old vet since she's the one that prescribed the Clavamox, but you talk to who is available. He also recommended skipping the ab and talking the the other vet to see if urine culture indicated another ab would work with his infection.
 
I'm late to the party, but I would definitely skip the A/B if he is not eating. I have had them get nausea before from Clavamox, and it usually clears up fast with a skipped dose or 2. I am really careful to only give the A/B also after they have eaten at least a few bites - having taken A/Bs myself on an empty stomach, I know it is NOT the way to go!!!!! :razz:

Hope he is back to eating. I'd throw up salmon & trout too, lol, ewwwwwww!
 
OK. I've stopped the AB and since the old vet did the urine culture, the visiting vet doesn't have the results and doesn't know what other AB to recommend. I guess I'm in holding pattern until Monday morning.

Alex doesn't feel good and is eating hardly anything. I did get him to eat some yogurt this morning. When Stan picked him up to do ear poke this morning, he meowed and I'm thinking he is some pain--I assume from the UTI and now we're not even treating it. It's a vicious cycle. The visiting vet did recommend skipping the insulin altogether, but from stuff I read last night, I haven't done that yet.
 
Darn, Ginny. Would a visit to the emergency vet be out of the question? Wonder if there is a reason for a off urine culture that is not a UTI? If he had no symptoms for a UTI? I wish he was eating. Baby food sometimes works - be sure it's the kind without spices or onions.
 
Have you checked for Ketones lately---I saw in the SS they were neg about a week ago, have you checked since then?
 
I have to take hubby to the airport in a couple of hours and I have no idea how I could possibly get Alex in his carrier and to the ER vet alone. And then once we're there, will he allow them to treat him?

I will go to the store and get some baby food.

I haven't checked for ketones lately since he's been staying in the 200s, but will try to do that soon. I changed the litter box this morning and so far, nobody has made a visit. That concerns me too.
 
I always thought that ketones were consistent with high bgs--BUT, they can develop ketones with bgs in the 200s. When Kitty went DKA, she had a UTI and got really picky about her food. She was also being severely underdosed on her insulin needs. She had no ketones on Friday and was at a level of 50 on Sunday and in DKA.

No, I really don't think that is what is going on with Alex---but, I would check to be safe.
 
Ketones are moderdate to large.

Visiting vet says to give Karo (why?) and then to shoot his normal dose in about an hour.

The old vet says she would normally advise me to take him to the ER, but she knows first-hand how out-of-control angry he gets when he's stressed. She wants to know if I want
1) to wait another 12 hours to see if he improves or
2) to take him to the ER.

Hubby is away for the rest of the week and I'm stressed out too.
 
Ginny......you tested for Ketones and they are moderate to large?

I use Reli On Ketone strips...the range for moderate is 40 and large is 80. Is this what your range is for moderate to large?

Kitty was 50 when she went into DKA. Not eating, high ketones and infection are three of the main contributors to DKA. Inadequate insulin is the other player in going into DKA.

If I am understanding correctly and Alex has a UTI, is not eating, and has a ketone test moderate to large---you need to take him to the ER vet.

I have been down the DKA road.......please try to head it off.
 
I see you are on line....do not wait. I am not sure you can stop this at home....he needs fluids and insulin....

You want to talk...pm me with your phone number
 
Ginny, are you sure the ketones are mod-large? do you do SQ fluids? you are already in an emergency situation now .... a cat that is not eating and has high ketones is one step from DKA. Not to frighten you but the next few hours are really important.
 
I don't know anything about DKA except you need to avoid it. If ketones are testing that high, then you do need to get Alex to the vet. Stressed out or not, DKA can kill. It is an emergency situation. His other symptoms are saying loudly that something is wrong and I doubt that waiting 12 hours will make that any better.
 
Ginny, Nancy has much experience as anyone on the board with ketones....follow her advice.

Like Nancy and Wendy said.....I am not trying to frighten you, but Kitty was in decent shape, just acted like she felt bad...I went outside for an hour and came back in to find her in a stupor...it was awful. You don't need to wait. At some point in this you are going to need vet assistance.....
 
I say get to ER Vet ASAP. Once there they can give him a little gas so they can treat him and he needs to be treated.

Please take him.
 
Hello All,

I just got back from the Vet ER. I warned them about Alex's disposition, but they were still very willing to treat. The vet I finally got assigned to has a diabetic cat of her own. Without sedating him (yay), the found out his BG was about 274 (which wasn't too bad considering he (and I) was stressed to the max and did a urinalysis that said he has ketones. No ****, Sherlock, that's the reason I'm here. From my waiting room, I could hear him hissing and "barking" at them. She says mild DKA and he will stay overnight to receive fluids and insulin. Tomorrow, their policy is to release them by 7:30am to their normal vet or I could see the internist there. Since the transport is stressful and I don't think either of the vets I've been working with have any experience with diabetics, I'm going to go see him.

So, for tonight, it's just me and Audrey.

Thanks for everyone for your advice and concern!
 
Whew......I am glad to hear from you. So glad you got him there before the DKA progressed---timing is very critical in treating it.

Good Luck with the internist tomorrow and please update with his progress.
 
Payne and I are sending our warm thoughts :mrgreen: and you both are wrapped in arms and paws .... but sometimes you need to watch out for those paws!!
 
I will keep everybody updated.
And thank you so much for telling me to check for ketones. I really thought that was something I needed to watch when his BGs were higher.

I also meant to tell you I was on my way to the vet, but the PC locked up and I was in a big hurry.

I hope Alex forgives me for this vet visit.
I also feel like I did something wrong, but am not sure what is was. Was it the UTI, the AB, the new flavor of food, that put him over the top?
 
You did nothing wrong-----and Alex is glad you took him to the vet, he needed immediate help. Kudos for being proactive and getting Sir Alex to the ER.
 
Wow you hit the jackpot. A vet with her own diabetic cat :-D an internist to consult with @-) .

I'm so glad you got him there. You should see if these vets also have a private practice you could go to.

I hope you and Audry have a good night.
 
Ginny & Alex said:
Visiting vet says to give Karo (why?) and then to shoot his normal dose in about an hour.

The old vet says she would normally advise me to take him to the ER, but she knows first-hand how out-of-control angry he gets when he's stressed. She wants to know if I want
1) to wait another 12 hours to see if he improves or
2) to take him to the ER.

Hubby is away for the rest of the week and I'm stressed out too.
Click to expand...

Why the heck did he say give Karo? It sounds like your old vet knows more than the visiting one. So glad you got him to the ER but sorry you have to deal with all this when DH is away!


Ginny & Alex said:
I hope Alex forgives me for this vet visit.
I also feel like I did something wrong, but am not sure what is was. Was it the UTI, the AB, the new flavor of food, that put him over the top?
Click to expand...

You did everything RIGHT by getting him to the vet! Think what might have happened if it weren't for this board! He's in the right place for the night. :YMHUG:
 
Oh gosh, somehow I missed this thread when I was on earlier today. Sounds like a rotten day, so sorry! :YMHUG:

You didn't do anything wrong, sometimes it just happens. Ketones come from a combo of too little insulin (not necessarily high BGs per se), not eating, and/or infection as I understand it. They can come on pretty fast, and some cats seem prone to them, some don't.

His numbers actually look pretty decent to me, so I never would have guessed. I'm glad everyone encouraged you to test and you were able to catch it before it got any worse.

Once he is back home & safe and sound, it means you are now in the "ketone kitty" crowd, where you have to be more aggressive than others with the dose. They just won't tolerate sitting in higher numbers as long as cats that don't have a history, and you need to keep them as much as you can in lower numbers.

Of course like I said his numbers aren't that bad and I'm sure his not eating is what played the key role in ketones developing, but maybe that is a wake up call to all of us that we have gotten complacent with thinking even yellows are ok.
 
Sorry to hear you had such a scary day. Hope all goes well tomorrow. So glad you got him to he vet before there was serious trouble. Keep us posted when you can.
 
Ginny, I just wanted to apologize for not connecting the dots and reminding you to test for ketones. Low dose + low eating is a recipe for ketones, and it just didn't click for me. :oops:

I am really grateful that there were people here who did connect the dots and helped you get Alex to the ER. Hope he is all better soon!!!!!!
 
Ginny, when I look at your SS the recent #'s look good but what pops out is in less than 2 months you have cut his daily insulin in half. Just by looking at his #'s it seems fine but knowing what we know now, that he throws off ketones, you are going to need to watch his insulin intake.

The #1 cause of DKA is not enough insulin, #2 is infection, #3 is ketones and then not eating ..... my line in the sand is not eating. If we see ketones and she doesn't eat, we are in ER. You did really good taking him in so quickly.

Let us know tomorrow how everything is.
 
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