Back from holiday - Sooty has severe UTi - Questions

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amy keay

amy keay

Member Since 2018
Hi

Came back from holiday on Thursday and my neighbours had been giving the injections and looking after him whilst we were away. I was texting and they said that he has been absolutely fine whilst we have been away and acting normally.
Notified he wasn’t quite right and he later vomited his tea on Thursday evening.
Took him to vets on Friday - they diagnosed severe UTI and prescribed antibiotics and Metacam.
Been giving him the tablets (he had 1 24 antibiotic injection on Thursday) and we have administered 2 tablets.
He’s got zero appetite and is hardly eating but testing his BG he is 23.2 this morning (amps). We lowered his dose to 1.5u before we went away and the vet said to continue to carry on with that dosage as the infection may be causing the BG to rise.

How long does it take for the antibiotics to start working ?
Will it be the infection / antibiotics that are causing the decrease in appetite ?
I read on here that the vets can give an appetite stimulant / anti nausea drug ? - Is that a temporary drug (I.e last for the day it is administered or will it be long lasting ?)
Very worried about my little man - he’s not right, any help greatly appreciated

Xx
 
Which antibiotic? A lot of them can cause nausea, especially Clavamox

Anti-nausea meds like Cerenia are given daily....there's also one called ondansetron...sometimes one works better than the other and sometimes you get the best results from both

I don't understand why your vet would suggest staying with a lower dose when there's an infection...do you have any more recent tests to put on your spreadsheet?

Yes, the infection can raise the BG but you also don't want him sitting in high numbers very long, especially with not eating + infection......add "not enough insulin" and you have the recipe for a DKA.

I'd return to your pre-vacation dose ASAP and just test enough to keep him safe
 
Hi

We are on clavaseptin twice daily, Metacam once a day.

My neighbours didn’t test bg whilst we were away so I’ll start testing again and add to the spreadsheet.
Is it ok to raise the insulin unit up or could I be getting a high am shot because of the infection ?
I think I’ll give a 2u dose this morning based on his amps reading and keep an eye on him.
I’ll also ring the vets tomorrow and ask for some anti nausea tablets.
He’s not a happy boy at the moment
Xx
 
Vet said to stay on the 1.5u as he was on that for the 2 weeks were away and all was ok
Also a little high is better than a hypo ?

I’ll all confused, (AGAIN !!)
 
depends on how much "a little higher" is.....Yes it's safer to be too high than too low, but the recipe for DKA is not eating + not enough insulin + infection/inflammation and Sooty has 2 of the 3. (actually, all 3 since he's not eating, we know there's infection, and with a 417(23.2) he's not getting enough insulin)

If he's over 200, I'd go back to the dose he was on before you left, syringe feed (if necessary) and test several times over the next several cycles.

When the infection starts to respond to treatment, his numbers could come down but that's why we test....to make sure he stays safe. It's not like all the sudden the infection will be "cured" and he'd be back to "pre-infection" numbers immediately....as the infection clears, his numbers should go gradually down.

23.2 (417) is way too high....not a "little bit" too high
 
Who did the ketone blood test. You or the vet?
I would keep testing for ketones while the infection is present, he’s not eating and the BG is high.
Do you have Ketostix to test the ketones at home?
I agree with Chris about getting the insulin dose back to pre vacation dose.
 
Hi

The vet did the ketone test and yes I have the strips - I’ll test when I can (when he does a wee)
I’ve just given him 2u and I’ll test his bg today and see where we are at and add to spreadsheet.

He’s had a little bit of food (about half a sachet) and a bit of chicken.
Should I try to get him to eat little and often today and test bg or skip the food ?
I have chicken and tuna in spring water.
He’s due his antibiotic at 8 along with the Metacam.
Il test his bg at 9 +2 and see what it says.
 
I would feed him often, even if he only eats small amounts. Don’t skip the food. It’s important he eats.
When you give the metacam make sure he has eaten a good amount beforehand. Metacam must be given with food.

Great you have strips to test for ketones!
And I’m glad you upped the dose of insulin.
 
I mixed the Metacam into some tuna yesterday and that seemed to work so that’s the plan today.
I have been finger feeding him pate which sometimes seems to work so I’ll continue with that too (if he eats a little it’s better than nothing).
Antibiotic time and Metacam time in 15 mins (is it ok to give them at the same time one at a time -?? Metacam first and then antibiotic)
Big test at 9.
Thanks for all your help
 
+2 20.0 (will add to spreadsheet)
Before we went away we were giving 2.5u (I think that’s what we need to be giving or heading towards that)

I’ll test again at +4 or +5 and report figures on spreadsheet.
 
Just tested again +5 and we are at 18.3 (far from ideal)

Can the infection cause insulin resistance ?
I vaguely remember this and he has had a couple of UTI’s and we have really struggled with the insulin dosing

I’ve been feeding him chicken today (and he is munching).
Is that good enough or should I be giving him food like pate or a sachet of felix ?
I’ll add this to the spreadsheet and test again for the PMPS
 
In the SS, I would leave a line inbetween the holiday and the restart of your testing so we can see easily where we are up to.
Feed him whatever he will eat at the moment if you are struggling to get him to eat. Chicken is fine. Main thing is he eats so you can give the insulin.
The infection is probably causing the higher numbers.
Which country are you living in?
 
Hi

I’m in the UK (I think the times on my ipad are still in holiday mode as I noticed the times of my messages say otherwise so sorry if it’s confusing)
It’s 13.30 here and we are due to give the next insulin at 19.15 tonight (and antibiotics and Metacam at 20.00)
I’ll amend the spreadsheet so I know when the testing restarted and when we were back - makes sense to do that.
I’ll continue with the chicken for now and hopefully he might want some tea a bit later before his jab.
At least I’m getting representative results on the BG as it’s not influenced by food
I just hope the antibiotics start working soon - I’m guessing it might take a few days if the infection is severe (I didn’t ask the vets what that meant)
 
PMPS 22.5

I’ll give him a 2u dosing as I probably won’t be awake during the night to ensure he eats etc (although I probably won’t sleep much)
Will test again in the morning and aim towards increasing the dose up to 2.5u
I’m at home all day tomorrow so I can keep an eye on him.
 
Help with numbers !!

I’ll add these to the spreadsheet in a minute but if anyone is there can someone give me some advice please ?

Today
AmPS - 23.5
+4 - 15.9
+7 - 25.3 !

I did a ketone test this morning and it was negative but this infection has got hold and I’m not sure that the antibiotics are working.I upped his dose of insulin to 2.5u this morning from 2.25 last night - could he be bouncing or the infection causing the high numbers ?
He’s eating chicken and had 1/4 sachet of Felix this morning but very lethargic and not a happy boy
 
Hi Amy
I wouldn't have thought you're seeing a bounce as the +4 15.9 isn't exactly low to bounce from. It could also be that the dose is starting to wear off at +7 although that's a little early and without previous data to show a +7 number it's hard to say.

It's very likely that the UTI is causing higher bg at the moment, yes, and it could stay high until the infection subsides. Pain and general discomfort can also elevate bg. Unfortunately UTIs are common in diabetics and very often persist or come back, so this is something to keep an eye on.

It's good that he's eating despite not feeling great. Cats who are really poorly have no interest in food so for now you're doing pretty much all you can do I think. Obviously if he starts to act as if he's seriously unhappy, call the vet.

Get a couple more tests if you an before pmps and we can see what's what then.
 
Thanks for the reply - I’ll get a couple more tests in before Pm shot and record these. I didn’t think it was a bounce either but thought I’d put it out there just in case.
I’m waiting on a call from the vets as he’s been on antibiotics since Friday and as yet no change ? The vet also said it was a severe UTi but I don’t know the extent.
Should I ask for a change in antibiotic ? Or can I expect things to hopefully get better soon ?
I’ll be testing as often as I can and recording them
Also what dose of insulin should I give tonight ? We’ve never previously gone above 2.5u so a bit reluctant to give anymore (especially when I won’t be able to test very often during the night)
 
I think it takes as long as it takes to clear an infection... vets (like human doctors) always say you should complete the course and not stop taking the medication if you feel better, so that the infection is properly cleared up. Some infections can be stubborn though and require a further course - you don't know about that yet and it's still quite early days to see an improvement. If there's no change when this course has finished, the vet may or may not prescribe a different antibiotic, but there are usually certain ones for certain conditions as they work in slightly different ways.

BG is probably not going to be "typical" until the infection subsides so you don't want to raise the dose unnecessarily at this stage. It might be better to stick to the current dose for a while yet. But see what the vet says about that, and other people here. We all have different experiences and although many are similar, sometimes someone is going through exactly what you are so is well placed to help on specifics such as dosing.
 
Hi Diana

You’re right about the Bg not being typical - just done another test and we have dropped to 23.8 (+8.5 since AM shot)
Will obviously do a PMPS to know what to dose at but probably will do 2.5 or 2.25 depending on the numbers

Hopefully someone who is going through this will see this thread - is it worth starting a new conversation about dosing with infection and antibiotics?
 
Yes worth starting a new thread if you have specific questions, so people can see what you need help with straightaway. I'm sure many people here have been in this situation so see what they say.
 
Hi Diana

I think (hope and pray) that we are making good progress.
I’m testing bg am and pm (minimum) and he is back on a consistent 2.5u dose (pre vacation dosing)

I must admit I didn’t read the packet of antibiotics correctly and was only giving him 1 tablet when I should have been giving 2 (morning and night). He’s been on the correct dose for 2 days now. He’s eating well, is slightly more active (he even had a play last night !) and seems generally a bit better.
His BG is still high but I suspect that the infection is still running its course and we have only been on antibiotics for just under a week and I know from reading on here it can sometimes take a few weeks to clear up.
We’re off to the vets again tomorrow so I’ll see what they say and take their advice. The vet did say that if he wasn’t improving I could hospitalise him for fluids to help but he seems to be ok ?
Not sure if you’ve had any experience of the flushing of fluids and whether it’s worth doing ?
Thanks for thinking of us - that’s really nice of you

Amy and Sooty
Xx
 
That sounds encouraging, Amy!
Ref the fluids - take your cue from the vet, but if Sooty is ok, is eating normally and even playing, and shows no sign of ketones, then probably not essential. See what the vet says and let us know.
 
I tested Sooty for ketones on Monday and it was negative and the vets tested last week and that came back negative too.

He’s not eating a lot but I did read that the antibiotics can cause a bit of nausea.
He is eating chicken though still and munching little and often so I’m fairly happy that he’s eating enough.
See what the vet says tomorrow and take if from there.
I’ll let you know how we get on....
 
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