Cat in ICU (now out) 7/26 [bg broke 200's]

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He sat for 2 minutes and is back in motion.
Gave 3 ml furosemide.
Got hopeful when he sat for a moment.
 
Woodsywife said:
Mannitol is iv only. Your regular vet should be able to give it. They might have to order it and if they do surgeries where they use iv they can administer it. If nothing else they should be able to find someone local for you.
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I have Mannitol. I carry it with me when I have him with me. What I don't have is someone administer it. I don't know how a vet would get a catheter in without sedation.....my emotions go up and down in waves.
 
apple said:
@Tanya and Ducia Where does you husband put the non stop motion?
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He still stands by what I posted earlier:

1.Enough liquid in the brain that can cause brain's compression would give Apple lethargy, not walking back and forth (ECID, of course). Having small amount in, the one that does not cause compression doesn't call for Mannitol;

2. Electrolyte imbalance could cause dysphoria symptoms/disorientation/being frightened;

3. Getting electrolytes checked ASAP/normalize the levels ASAP is the way to go - given it is approved by vet professional;

4. Small amount of liquid in the brain can be addressed surgically later on, if necessary, AFTER the electrolytes are balanced to norm and the clinical condition is assessed after the SQ f therapy.

Again, he/I do not give an action plan but rather what to research/to try/to discussed with a vet if emergency relief of Mannitol is unavailable.

Without seeing blood-work results, CT scan images, current and past diagnosis all of it is only an educated guess by human med professional given in order to let you know that there maybe other ways to get Apple feel better in the absence of Mannitol.
 
Tanya and Ducia said:
He still stands by what I posted earlier:

1.Enough liquid in the brain that can cause brain's compression would give Apple lethargy, not walking back and forth (ECID, of course). Having small amount in, the one that does not cause compression doesn't call for Mannitol;

2. Electrolyte imbalance could cause dysphoria symptoms/disorientation/being frightened;

3. Getting electrolytes checked ASAP/normalize the levels ASAP is the way to go - given it is approved by vet professional;

4. Small amount of liquid in the brain can be addressed surgically later on, if necessary, AFTER the electrolytes are balanced to norm and the clinical condition is assessed after the SQ f therapy.

Again, he/I do not give an action plan but rather what to research/to try/to discussed with a vet if emergency relief of Mannitol is unavailable.

Without seeing blood-work results, CT scan images, current and past diagnosis all of it is only an educated guess by human med professional given in order to let you know that there maybe other ways to get Apple feel better in the absence of Mannitol.
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What about his eyes? They still do not move.

He gets fluid if another cat licks him and moves his head.

I don't know how much fluid has been on his brain in the past. I've never known quantity.

Could he do something like Pedialyte?
 
Squalliesmom said:
Exactly what I was going to suggest!!! I think that's a great idea!
ETA: The neuro knows Apple, right? Then he/she should recognize that this is not normal behavior for Apple.
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She and I both sat and watched the same behavior. She called it wonderful, he's never looked so good. I called it inappropriate and was told I argue.
 
apple said:
What about his eyes? They still do not move.
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If there is liquid in his brain pressing against/ compressing the stem area of the brain then it could affect the eye motion properties. We need to know if brain ventricles are dilated. Again: only a guess in absence of MRI/ brain scan images;
apple said:
I don't know how much fluid has been on his brain in the past. I've never known quantity.
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any chance to ask for/ request/ demand the copies? Not only it would make this conversation meaningful, any vet professional would need to see them....
apple said:
Could he do something like Pedialyte?
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Instead of SQ f? No, it is not a substitute. But you can try it.
 
apple said:
She and I both sat and watched the same behavior. She called it wonderful, he's never looked so good. I called it inappropriate and was told I argue.
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Well, maybe if she sees him stumbling heedlessly around in his own natural environment she will realize it's not the wonderful behavior she thought it was. It might not help but it can't hurt to try, right?
 
I can't access Google docs at the moment, so putting notes for myself here.....
1m:07sec eat
Wander
1m:22sec man cave
Wander
1m:20sec in cat bed
Wander
 
Squalliesmom said:
Well, maybe if she sees him stumbling heedlessly around in his own natural environment she will realize it's not the wonderful behavior she thought it was. It might not help but it can't hurt to try, right?
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He doesn't stumble. I think of it like and army tank. He goes forward over anything. He doesn't go around things he should and used to go around. It's always over and forward.

Thank you for the suggestion. I think journaling his constant movement might help.
 
Tanya and Ducia said:
If there is liquid in his brain pressing against/ compressing the stem area of the brain then it could affect the eye motion properties. We need to know if brain ventricles are dilated. Again: only a guess in absence of MRI/ brain scan images;

any chance to ask for/ request/ demand the copies? Not only it would make this conversation meaningful, any vet professional would need to see them....

Instead of SQ f? No, it is not a substitute. But you can try it.
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The last image he has done, his body was right in all manner of function. The issues arose after the CT. I don't know how to get new brain info.
 
Woodsywife said:
Regular vet can call to get reports. I doubt they would deny him. Vet can also give a sedation without anesthesia to get the iv in.
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I will ask them if they got the records. Every time I check in they (the university) read the list of vets that are to be notified and sent records.

I thought sedation and anesthesia were the same.
 
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apple said:
I will ask them if they got the records. Every time I check in they read the list of vets that are to be notified and sent records.

I thought sedation and anesthesia were the same.
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It's a question of degree. Sedation meds can be used to relax and quiet the animal while leaving it with some degree of consciousness. Airway intubation is not involved. General anesthesia renders the animal unconscious and airway support through intubation is required.
 
Hi all,
Since our kitties are a team effort, I wanted to say thanks for the moral and mental support. It means the world. I'm the only one that was at the u and had nobody for support except this board. So, thank you, thank you, thank you.

My mom watches him for a bit and I left the house for a bit.

The plan for now:
Give Pedialyte
Force feed ad for nutrition
Check #
If over 200 post on the board for opinions
Bupe for pain

Contact vet for records/ electrolytes
Ask vet if he can offer supportive care while he tries to recover.
 
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apple said:
What about his eyes? They still do not move.

He gets fluid if another cat licks him and moves his head.

I don't know how much fluid has been on his brain in the past. I've never known quantity.

Could he do something like Pedialyte?
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@apple
My heart is still wrenching over what you're both going through.

In mind with all that's being discussed here, I will add a few ideas/possibilities for consideration in the context of this discussion and what you are going through

What @Tanya and Ducia mentioned about electrolytes possibly being off rings familiar and imo worth considering at least as a possible contributing factor.

Unflavored pedialite would be a quick go but it does have dextrose which could affect his bg. (mentioning so you won't be alarmed if it affects his bg). Alternatively, a home made beef or chicken broth or "raw liver shake for sick cats" might be worth a try.

Here is link to an fdmb thread about bone broth re electrolytes. It's about dehydration (idk if your kitty is dehydrated but it's information) with discussion and info about pedialite and electrolyte alternatives (bone broth mentioned) that don't contain the dextrose that pedialite has in it:

http://www.felinediabetes.com/FDMB/threads/what-to-give-to-a-dehydrated-cat.138658/

In this thread is also a link to home testing for dehydration (it's in bjm's signature):
https://docs.google.com/document/d/1r6ktdF7AMJCYHgPkVQWFUFy5Ag6OnbmfNfQqL3zX_88/mobilebasic

Also, Here is link for raw liver shake recipe:
http://www.felinediabetes.com/FDMB/threads/the-liver-shake-for-sick-cats.30432/

Bone broth (and even plain meat broth such as chicken) and the liver shake have gotten us through some rough spots with some seriously sick kitties in our household.

Hang in there and Heaps more feel better vines :bighug::bighug:for you and you kitty. :bighug::bighug:
 
HWright said:
@apple
My heart is still wrenching over what you're both going through.

In mind with all that's being discussed here, I will add a few ideas/possibilities for consideration in the context of this discussion and what you are going through

What @Tanya and Ducia mentioned about electrolytes possibly being off rings familiar and imo worth considering at least as a possible contributing factor.

Unflavored pedialite would be a quick go but it does have dextrose which could affect his bg. (mentioning so you won't be alarmed if it affects his bg). Alternatively, a home made beef or chicken broth or "raw liver shake for sick cats" might be worth a try.

Here is link to an fdmb thread about bone broth re electrolytes. It's about dehydration (idk if your kitty is dehydrated but it's information) with discussion and info about pedialite and electrolyte alternatives (bone broth mentioned) that don't contain the dextrose that pedialite has in it:

http://www.felinediabetes.com/FDMB/threads/what-to-give-to-a-dehydrated-cat.138658/

In this thread is also a link to home testing for dehydration (it's in bjm's signature):
https://docs.google.com/document/d/1r6ktdF7AMJCYHgPkVQWFUFy5Ag6OnbmfNfQqL3zX_88/mobilebasic

Also, Here is link for raw liver shake recipe:
http://www.felinediabetes.com/FDMB/threads/the-liver-shake-for-sick-cats.30432/

Bone broth (and even plain meat broth such as chicken) and the liver shake have gotten us through some rough spots with some seriously sick kitties in our household.

Hang in there and Heaps more feel better vines :bighug::bighug:for you and you kitty. :bighug::bighug:
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Thank you. I looked at the bottle for quite some time reading dextrose.......and thinking, I think that's sugar, hmmmmmm.

I bought it and figured if I don't use it for him, I can for me.

I'll read about the broths.

He probably won't get Pedialyte today. He got his sugar from another source. He found a Perkins muffin my mom brought and ate a bite. Yes, not healthy, but he found it, asked and ate in his own. Right now, he gets almost anything he wants to eat.
 
at this point... eating a muffin is a nice normal behaviour..... so that's a plus.

from earlier today....
dysphoria in a cat - symptoms can be vocalization, agitation, pacing, withdrawal from owner or from environment, lack of grooming, abnormally rapid breathing




the zombie like walking that you describe sounds like he can't see where he is going ( imho)
the swelling could be pushing on his optic nerve.


I hope that tomorrow your local vet can have some ideas and suggestions
 
So sorry you had to face that whole horrible university experience all by yourself. :bighug::bighug::bighug: Know that we're with you in spirit and you've got all our support! I'm glad you're going to look into the electrolyte imbalance, I think that has the potential to become critical. Sending more prayers and healing vines for Apple, and for you, as well. Hope you can get a little rest, too. :bighug::bighug::bighug:
 
Is he off furosemide now? That can affect electrolytes. I had a cat that had too much furosemide. She was dysphoric and very thirsty. She had other problems though too possibly causing the dysphoria.
 
MJW said:
Is he off furosemide now? That can affect electrolytes. I had a cat that had too much furosemide. She was dysphoric and very thirsty. She had other problems though too possibly causing the dysphoria.
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He got one does sat & one does Sunday. The patrol walking was happening before the furosemide. The furosemide is to reduce his head swelling.
He didn't get any today because he asked for muffin again. I'm trying to walk a line between he asked and ate muffin (normal behavior) and head is swollen (needs meds that

Started this then needed to leave......will post more later today.

The muffin is a hit. He ate part of a burger,- cat food, won't self feed.
Bought a food scale and a people scale to start weighting him and his food. I usually go to the vet to weight, I don't think his mental health is up for goong to the vet, even if it's just for a weight.

More later today.
 
apple said:
He got one does sat & one does Sunday. The patrol walking was happening before the furosemide. The furosemide is to reduce his head swelling.
He didn't get any today because he asked for muffin again. I'm trying to walk a line between he asked and ate muffin (normal behavior) and head is swollen (needs meds that

Started this then needed to leave......will post more later today.

The muffin is a hit. He ate part of a burger,- cat food, won't self feed.
Bought a food scale and a people scale to start weighting him and his food. I usually go to the vet to weight, I don't think his mental health is up for goong to the vet, even if it's just for a weight.

More later today.
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Thanks for the update, we worry about all the kitties here like they were our own! So glad the muffin is a hit! And the burger. Better than not eating anything! Yeah, I wouldn't subject him to another vet visit if you don't have to. I use a baby scale to weigh my guys at home. If you don't have one, you can usually pick one up on Amazon fairly cheaply. Is he still doing the patrol walking? Hoping the furosemide helped at least a little bit. What did his regular vet say about electrolytes? Sending hugs for you, and gentle scritches for sweet Apple. :bighug: :cat:
 
to weight Marvin, I get on the scale weigh myself, pick him up, weigh both of us, subtract mom's weight = Marvin's weight. So if you have a people scale try that :)
 
7/25
Action plan:

1. Now have digital people scale to weight cat (if it works, no vet trips for weigh-ins)
2. Now have digital food scale to more accurately monitor food intake
3. Allowing muffin eating; behaviorally appropriate, asks for muffin, takes a bite, goes to new spot, puts muffin bite on whatever surface he's on and then eats muffin; similar to pre-anesthesia event behavior......bites are about the size of a penny and depth to two stacked pennies
4. Allowing free feeding of Solid Gold Indigo Moon crunches, placed out about 10/15 at a time to track intake
5. Force fed A/D cut with water; quantity undecided
6. BG tested daily; numbers will be food influenced; with the anesthesia event, I don't want 2 hours without food available
7. If food influenced number reaches 250 or above, if he seems like he can handle 2 hours with out food, regular ambg/ pmbg to be done
8. Furosemide to be administered .3ml-.5ml ? How often, undecided / bg checked prior to administration; above 250 no dose
9. Buorenex administered .05-.2ml between 1 to 3 times per day depending on head & neck pain and activity level.
10. Recontact vet for how he can help support recovery
11. If needing to return to insulin ?? Which one....

Feedback:
How is my thought process in balancing the self feed with nutrients vs pushing his luck with sugar and exiting remission?

His muffin behavior is normal and he eats with some enthusiasm. I'm willing to go with some higher bg numbers in return for continued self feeding.

Force feeding- wondering if I should cut it with Gerbers baby food to increase the calorie count. Concerned the corn starch + muffin could over load his numbers. Not sure where to hedge his bets.

Higher fat food. Vet would like more fat in his diet. Suggestions for and easy to syringe food with higher fat content?

Insulin: before he went off the juice we were going to switch from lantus to lev. If he needs to return to insulin, would you go with lantus, what you know and have data on or would you make your move to lev?

Reason/s we were going to switch.....he expressed neurological symptoms while created by lantus; along with stinging when injected; over all lethargy during the first 6 hours after injection, he was miserable, like clock work. And the list of negatives goes on......that said it was what pushed him to remission. Unknown if lev could do that

Goal: gain weight
Mental health goal: return to mentally safe state. Carrier making any noise (cleaned it &/or moving it) and he changed his personality, worried he will be put in carrier. My guy is a road warrior, loves his carrier, would nap in his carrier etc..... now, need to get feeling okay with the carrier.

Afternoon bg 195
 
apple said:
nsulin: before he went off the juice we were going to switch from lantus to lev. If he needs to return to insulin, would you go with lantus, what you know and have data on or would you make your move to lev?
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I hear a lot of good things about Lev. From what I hear a lot of people switch to it because of the sting and because it seems to provide flatter BG numbers, I believe that the nadir is not in the middle of the cycle but more toward the later part of the cycle (+ 8 or 9), again every cat is different. I would switch to Lev if Marvin was on a larger dose, I may look into it if his BG are getting too low when I am away at work. Right now I am off so I can monitor and at this low dose on Lantus it is not stinging him.
 
Your action plan looks good. I would definitely try the baby food. I think Hi-Tor Neo is pretty high in fat, and blends with water easily for syringing. If I were you I would also try the Liver Shake. Pretty sure someone already gave you a link but to save you from going back through all that I'll give it to you HERE. Everybody says it works wonders.

Keep us posted! :bighug: :cat:
 
apple said:
7/25

...Feedback:
How is my thought process in balancing the self feed with nutrients vs pushing his luck with sugar and exiting remission?

His muffin behavior is normal and he eats with some enthusiasm. I'm willing to go with some higher bg numbers in return for continued self feeding.

Force feeding- wondering if I should cut it with Gerbers baby food to increase the calorie count. Concerned the corn starch + muffin could over load his numbers. Not sure where to hedge his bets.

Higher fat food. Vet would like more fat in his diet. Suggestions for and easy to syringe food with higher fat content?

Insulin: before he went off the juice we were going to switch from lantus to lev. If he needs to return to insulin, would you go with lantus, what you know and have data on or would you make your move to lev?

Reason/s we were going to switch.....he expressed neurological symptoms while created by lantus; along with stinging when injected; over all lethargy during the first 6 hours after injection, he was miserable, like clock work. And the list of negatives goes on......that said it was what pushed him to remission. Unknown if lev could do that

Goal: gain weight
Mental health goal: return to mentally safe state. Carrier making any noise (cleaned it &/or moving it) and he changed his personality, worried he will be put in carrier. My guy is a road warrior, loves his carrier, would nap in his carrier etc..... now, need to get feeling okay with the carrier.

Afternoon bg 195
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Wow and :bighug: with what you've been doing and your plan of action. As Lucy (squallie's mom) said, I also think your plan of action makes sense.

Re liver shake: yes worth a try and I'm glad Lucy reshared the link I included earlier. I make it with either chicken or beef liver (the chicken liver seems to appeal more with my Tribe), carrot juice and either spirulina, kelp or dulse granules. These items should be available in your local health food store. If you don't want to use raw egg yolk or if that doesn't appeal (as is the case with my fiv renal civie Azalea), I make it with plain powdered egg white and powdered egg yolk. ECID!
(Btw: adding that learned about liver shake here in fdmb thanks to members suggesting it during crises...so thanks to them it's become a staple go to with our Tribe).

Re baby food: yes but if you use it or other whole meats exclusively, I suggest adding a food supplement. I use ezcomplete food fur life. I mix about a teaspoon in with water and about 1/2 jar of the beechnut baby plain meat food (I often add in a bit of plain pumpkin or baby food plain squash).

Here's the link to ezc food fur life. Also
The owners, Laurie Goldstein and Carolina Liima, will send you a free sample pack to try. There might be a link on the site or you can email them directly from the site.
http://www.foodfurlife.com/

They've just started offering egg yolk powder, too. If you can't find egg white or egg yolk powders locally, here's where I've been getting my supply (I get the small packets bc a little goes a long way):
http://www.modernistpantry.com/egg-white-powder.html

I'm glad to send you some of my stash of these dry ingredients to help get you started.

Oh yes, re your vets suggestion to add fat to Apple's diet: perhaps try a bit of unsalted butter with his muffin bits? Light cream, diluted with a bit of water or mixed with assist food mix?
Egg yolk, whether raw or powdered, is a good source of lecithin (and not soy-based) that, while technically not a fat, may help assimilate fat and supports brain health.

Another thought I've had is to ask you if you've thought about homeopathic support in the mix with the traditional meds and nutritional support? If you're open to that, I'll gladly pm you or post here the name of my long-distance homeopathic vet who has helped us through several severe situations (he does telephone consults only so no vet treks needed).
 
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7/26

Current weight 12.2lbs ish (ish because number from new at home scale. Unsure how it correlates with vet scale)

Goal weight 13.5 lbs

Increased water intake

Dropping (or trying to reduce) muffin intake

Feed .06oz ad cut with water am

Edit: To do blood work vet would want anesthesia and I don't want that for him. So, no electrolyte information at this time.

2nd edit:
Patroling: still there, pace is not as frenetic. Will stop at moments and sit
Civvies: they give him a wide berth, kitten doesn't harangue him, others let him be
Poop: one poop since home
Sleep: I don't think he's slept since we got home
Purr: hear my first normal purr while testing his toes yesterday
Bathing: he's not had a normal bath since getting him back. Its spot washing kind of like I'd we had a bug on us and we swat that spot. He must quickly and with urgency was a spot, right there, NOW
Sitting: he does seem to sit in a spot for a moment or two longer
Over: yesterday he stepped over my mother's ankles instead of bulldozing his was over/on/through....
 
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Marvin's Mom - Nat said:
to weight Marvin, I get on the scale weigh myself, pick him up, weigh both of us, subtract mom's weight = Marvin's weight. So if you have a people scale try that :)
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Thank you for the suggestion. My scale doesn't have partial units. (Old school dial up) New one is digital. Althought the first reading made me think it was defective. Sixteen pounds. He's never been over 13.5lbs..... Next reading was 12.2lbs. He's got some eating to do.
 
apple said:
Thank you for the suggestion. My scale doesn't have partial units. (Old school dial up) New one is digital. Althought the first reading made me think it was defective. Sixteen pounds. He's never been over 13.5lbs..... Next reading was 12.2lbs. He's got some eating to do.
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If your scale gets jostled or moved it will affect the calibration and your next results can be out of line with the prior ones.

Is Apple particularly hard to deal with at the vet? I don't know why your vet would want to anesthetize him to draw blood! Even my most truculent and difficult cat doesn't need to be anesthetized to draw blood.
 
Squalliesmom said:
If your scale gets jostled or moved it will affect the calibration and your next results can be out of line with the prior ones.

Is Apple particularly hard to deal with at the vet? I don't know why your vet would want to anesthetize him to draw blood! Even my most truculent and difficult cat doesn't need to be anesthetized to draw blood.
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In his youth, he'd rip you to shreds. (So he'd say.....He was more talk than action, but, boy could he talk!) He would slap the vet or tech. Never bit or turn on you, just talk and slapping.

He (cat) gets very scared.

Vet thinks if would be less stressful of him to be out while blood is drawn.

Prior to the FD zillion vet trips, things has settled down to where he was calm at the vet.
 
apple said:
In his youth, he'd rip you to shreds. (So he'd say.....He was more talk than action, but, boy could he talk!) He would slap the vet or tech. Never bit or turn on you, just talk and slapping.

He (cat) gets very scared.

Vet thinks if would be less stressful of him to be out while blood is drawn.

Prior to the FD zillion vet trips, things has settled down to where he was calm at the vet.
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Given his serious issues with anesthesia I'd have the vet try everything they can to get blood without anesthesia, maybe a mild sedative (kitty valium-ish thing).
 
My vet uses a cat bag and muzzle for Gizmo. If the tech is good, once the cat is in the bag and muzzle in place it shouldn't take them more than 2 minutes to get the blood.

https://www.amazon.com/Guardian-Gear-Nylon-Cat-Muzzles/dp/B002T1ICX0/?tag=felinediabetesfdmb-20
https://www.amazon.com/ASOCEA-Groom...Cats/dp/B06Y1S9QVJ/?tag=felinediabetesfdmb-20

Once the muzzle is on him he kinda goes limp for a bit and then the bag goes on and before he can react they are usually done. Less stress on him and safer for the techs/vet.

My vet won't even consider sedation for routine blood work - too risky.
 
I agree about finding alternatives to anesthesia for blood draws, especially in Apple's situation. Idk if even light sedation would be problematic for Apple. but at least light sedation can be just enough to calm and it clears the system quickly.

Idk if some other ideas are worth a try but I'll mention them just in case. I've had some reasonably good results with these for calming pre-vet visits (re three of my cats who've gotten the "fractious" moniker for different reasons: high kill shelter fear-aggression defenses; high kill shelter induced fear of abandonment panic attacks; the third (azalea) got a bad rep one time when she was sick, had severe nerve pain and was initially handled by a new tech who wouldn't listen to me and had no nuance skills.

I've had best pre-vet visit calming results with:
Bach rescue Remedy (pet or kids version) starting the night before;
Nat mur homeopathic (in lieu of rescue Remedy);
Thunder shirt or lightweight leash harness (for my fear-aggression kitty who responds as if she's temple grandin in her calming compression device).

Tried Valium once with my fear-aggression kitty, having been warned ahead of time by the vet that Valium can go either way. In Spunky's case, even 1/2 of the lowest dose had her literally climbing the walls til it wore off. ECID.

Members have mentioned other calming meds but, alas, I don't recall what they are.
 
My vet uses a plug-in that has a smell that calms kitties. And he uses a clip at their scruff; he swears by these natural methods of calming pets. I don't remember the name of it but I'll try to find out tomorrow for you.
 
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