Annie: Diarreha and Vomiting

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Barbara Boughton

Member Since 2015
Hello. I'm new to the forum and I apologize for not posting first to the introduction section. I'll do that later today. This is a long post but I wanted to get some feedback, and provide info about Annie's situation.

I have a diabetic cat Annie diagnosed about a year ago. I took her to the vet Wednesday and the next day she started exhibiting signs of stress or illness. On Wednesday the vet did what looked like a thorough exam and did not find anything wrong. They also took a blood test. Yesterday the vet called and said her glucose levels were a little low and to reduce the amount of Lantus I'm giving her from 1 1/2 units to 1 unit. She has had glucose curves in the past at the vet and Wednesday I also got a home glucose kit to do a curve at home.

On Thursday Annie pretty much hid all day and also had some considerable diarrhea and a little bit of vomiting. When I spoke to the vet we discussed whether she might just be stressed--she's a sensitive cat--and she said to call her if the diarrhea continued. On Thursday she ate less than she usually does. I discovered yesterday evening after coming home from work that she didn't really eat at all and vomited a few times, about the size of a quarter each time. Last night I changed her insulin to 1 unit and today she seems a little better, she hasn't vomited today, had less diarrhea last night, ate two small mouthfuls of food and has been more interactive. Right now she appears to be sleeping deeply on my bed. She's refused treats I usually give her yesterday and today.

I'm taking her to the vet in about half an hour, along with a sample of her stool. I can assist feed her as I had a kidney cat for several years. But I was wondering if you have any feedback? She is on Lantus insulin and Royal Canin diabetic cat food. I also tried Hills/ MD low carb food today and that was what she ate.

Any feedback welcome.

Thanks,

Barbara
 
How low was her blood glucose?
I'm glad you got a glucometer, so you can test her at home and keep her safe.
She may have been lower than normal (for her) on Wednesday and then her liver reacted and she was higher on Thursday and didn't feel good because of it. I am just speculating.
Good luck at the vet this afternoon.
I'm glad she's eating some. Sending eating vines her way.
 
She may need a different insulin dose.
She could have pancreatitis; it is very common in feline diabetics.
 
thanks so much or your replies. The good news is that Annie is eating today actually pretty well. But last night she did have diarrhea. No vomiting yesterday or today.

Yesterday the vet told me to give her fluids daily, try to get her eating with whatever she wants just for now, and then if she doesn't worsen, come back in a few days. I am going to post her numbers here and if anyone has any insight please let me know. I have had a cat with kidney disease and it looks to me from her results that Annie does have CKD, although the vet told me her numbers haven't changed much since last time we checked 6 months ago. Ok, here are what I consider the important numbers from Wednesday. I've provided the ones marked as abnormal

Fructosamine: 331
BUN 71
Creatinine 3.3
Glucose 52

Yesterday they did inhouse bloodwork, and the numbers here are those marked as abnormal:
BUN: 52
Creatinine: 3.2
Glucose: 74
ALP: 5
and the vet has written 2 numbers I don't recognize:
PCU: 38
TS 8.0

Thanks for any feedback everyone


Barbara
 
hmm. the glucose isn't up high.... maybe that's why it's flagged as abnormal.... they may consider it too low.
We don't.

As I recall, you need the urine specific gravity number to determine the CKD dx.
I'll tag @Marje and Gracie .... she's great at lab data.
 
Larry and Kitties said:
A USG of 1.017 indicates kidney insufficiency.
Click to expand...
I would say in Annie it indicates kidney insufficiency based also on her creatinine and BUN. But, just as a note, the USG can vary in a cat during the day based on the amount it drinks. There are other reasons besides kidney insufficiency why the USG in a cat might be low if the creatinine and BUN are normal. With normal creatinine and BUN, a lower USG can be a precursor to CKD but it can also be due to polydipsia from hyperthyroid conditions, liver insufficiency, and other things.

While her kidney values aren't too high above normal, Annie definitely has CKD and I think you need to find the values for calcium, phosphorus, potassium, and her hematocrit (to see if she is anemic) at the least. If her phosphorus is high (which can be typical in CKD cats), it could account for the vomiting. CKD kitties can also get acid tummies. Did your vet check her mouth closely for any ulcers? Does she sit in a meat loaf position and act like her tummy hurts? These are all signs of acid tummy. Quite often in a CKD kitty with acid tummy, they will vomit clear, foamy liquid especially first thing in the morning.

I would be sure you are feeding her a low carb, low phosphorus diet. You want to try and keep the phosphorus under 1% (the lower the better) or under 200 mgP/100 kcal. Again, the lower the better. You can look at this great Spreadsheet on Foods complied by Ann for her CKD kitty, Tess.

I'd also recommend checking out Tanya's Comprehensive Guide to Feline CKD as it is the gold standard for treatment of feline CKD.
 
thanks for your great and informative replies. I actually had a CKD cat, Savannah, and treated her with fluids, pepcid and diet for 4 years, and near the end of her life with prednisolone for IBD. She passed away this past November. Savannah however was a very different cat from Annie. Annie does not like to be handled and is very very easily stressed. For instance, when I took her to the vet this Wednesday and picked her up to put her in her box, she peed, necessitating a change of clothes for me. So right now she is eating but not vomiting, still having diarrhea but it is reduced, but is sitting in the meatloaf position. I will ask the vet about Pepcid and will look into other foods as soon as I get her eating enough. I did try fluids and as I well know starting these can be difficult. I was only able to get 50 ccs into Annie last night and just 25 ccs this morning. After she bolted out of the bathroom after the fluids, she left some diarrhea on the bedroom rug before hiding. She goes back to the vet in a few days, and I'll discuss mouth ulcers and ultrasound at that point.

With Annie, I'm really concerned about stressing her out too much vs. doing all the CKD interventions. Her phosphorous levels, calcium and potassium are all normal. Will need to look at her results for hemocrit. She has had treatment for hyperthyroidism in the past, and that disease can mask CKD. I'm very familiar with Tanya's site but will check out the spreadsheet on foods. Thanks very much! If you have any feedback thoughts at all on this latest post just let me know.

Barbara
 
Is there something Annie likes a lot - a treat, a toy, brushing? If so, we can work out a desensitization plan for her to work on reducing her stress with being handled.
 
Yes she likes dental treats. she did eat a little yesterday and her diarrhea was noticeably better. but is still vomiting a few little bits of foamy stuff each day. typical of CKD.

I'm pretty willing to try to get Annie through fluids and learn to do a glucose monitoring curve. My biggest concern though is the cost of her care, and it's heartbreaking for me to have to say this. The last two visits plus tests cost $700. which wiped out my little savings account since I'm recently divorced. And the vet wants to see her this week but I barely have enough now to make my rent as I don't get paid til the 10th. I asked about paying in an installment plan, but they said no. they said they do have a membership plan that costs $70 per month for 12 months and covers 5 visits with bloodwork with CBC, X-rays, blood pressure, fecal testing, urine testing and diabetes blood prick test. also vaccines. but Annie is likely to need more expensive bloodwork and possibly an ultrasound. anyone have any ideas about getting help with these costs? Any ideas welcome, thanks!

Barbara
 
You may find 1/4 tablet of plain Pepcid AC about 20 minutes or so before feeding helps reduce the acid stomach caused by renal insufficiency.

You could check into the various fund raising programs online, such as GoFundMe, FundRazr, etc. Posting those on Facebook can sometimes get some help. Check your local humane groups and online for grants and aid.
 
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