Cecil

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Rhiannon Tuffin

Rhiannon Tuffin

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Hello

My beautiful boy Cecil (he was rescued about 8 years ago and we are unsure of his age, he is at least 10 but likely much older) was diagnosed with diabetes about a month ago. This is likely caused from steroids that he has been having due to IBS. After perking up a little bit with insulin treatment and reduction of steroids, in the past week or so he has stopped eating very much at all and has yesterday been diagnosed with HCM. He is a Maine Coon so I know this is quite common. He has fluid in his abdomen so they have given him diuretics to help with that.

I just can’t get him to eat anything substantial and he has already lost a lot of weight. It is also hard to manage his insulin as he’s not having proper meals. He gets excited when I get the food out, then sniffs it, maybe has one bite and then leaves it. I’ve tried different flavours of his normal food, scrambled egg, dry food etc all the same. He will eat treats although I know he can’t just have those alone. I’ve tried to put treats on his food but he just ignores it again

I was just wondering if anyone had any ideas of what I can try next? I have some cat soup (cosma) coming today and I’m in the UK.

Thank you!
 
Hi and welcome to the forum.
It sounds very much to me as if Cecil is nauseated. I would ask the vet for an antinausea medication that you can give at home each day. There is cerenia which is given daily. Or there is ondansetron which can be given 3 times a day, which is better for nausea. The ondansetron will need to be obtained from a human pharmacy after the vet has written a script for you.
It is really important that diabetic cats eat well so they can get their insulin and also because they must eat to keep ketones away.
I would let him eat whatever he wants at this point until you can get the nausea under control. If you can get some antinausea meds from the vet today, that is what I would advise. Also ask about an appetite stimulant, but you need to always give the antinausea med first before the appetite stimulant.
Here is a link on ideas to STIMULATE THE CATS APPETITE

What type and dose of insulin are you giving?
I’m going to tag @Wendy&Neko about the HCM.
Keep posting and asking questions
Bron
 
Hello thanks for your reply. He had an anti nausea injection at the vets yesterday but I’m not sure which one. He is on caninsulin 1.5 units 2 x a day at the moment.
 
Rhiannon Tuffin said:
Hello thanks for your reply. He had an anti nausea injection at the vets yesterday but I’m not sure which one. He is on caninsulin 1.5 units 2 x a day at the moment.
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The injection was most likely cerenia and will only last for 24 hours so I would ask for some tablet you can give daily at home. A nauseate cat will not want to eat.
Are you offering food 1/2 hour before any insulin doses?
 
I’ve been offering him food in the morning and evening before he stopped eating so much, now I am just trying to offer him food numerous times of the day to see if he feels hungry. I am tested his sugar levels before giving any insulin as suggested by the vet
He has a checkup in the morning so I will ask about a tablet thank you
 
Just a FYI moving forward. Diabetic cats do better with multiple meals/ snacks during both cycles and not just 2 meals a day.
Please let us know how you get on at the vet and how Cecil is progressing. Don’t give up.
 
He has dry food that he grazes on during the day, the meals offered is wet food in the morning and evening.
I will and thanks for the advice, I have rang to ask if they can give me any anti sickness medication for him before tomorrow
 
He ate about 1/4 pouch of food about 30 mins ago and he had some treats from my mum this afternoon - I got an anti sickness tablet from the vets so I’m hoping he will feel a little better from eating some food
 
Regarding the IBD, which can make them feel nauseous, talk to your vet about using budesonide as an alternative steroid. I'm assuming he was on prednisolone? Budesonide is locally acting on the GI system and for many cats does not impact their blood sugars. It didn't impact Neko's numbers, who had to go on a steroid but she could not take prednisolone due to her heart condition.

Heart conditions can also make them feel nauseous, the diuretics may help with that too.'

If the tablet you got is Cerenia (I hope you got more than one), it is bitter tasting so you may need to give it in a blank gel cap.

If you haven't seen them already, some tips on feeding and even syringe feeding if needed. Often syringe feeding a little food in will settle their tummy and they'll eat more on their own.
 
Thank you I will talk to my vet about that tomorrow. He was on prednisolone 5mg a day but it has been reduced to 2.5mg every other day over the past month and his tummy has been very settled.
The tablet is Mirtazepine and they gave me 2 doses as I am going back in the morning with him anyway.
He has eaten a small amount tonight, more than he has been at least but he seems to be more interested when anyone else but me is giving him the food
 
Mirtazapine is an appetite stimulant, not so much for nausea. Best to have an anti-nausea drug such as Cerenia (maropitant) or Zofran (ondansetron) to handle nausea before giving an appetite stimulant. Giving an appetite stimulant if they are still nauseous can lead to food aversion.

Mirtazapine also comes in a transdermal form called Mirataz, you just rub a little on the inside of their ear. It's much easier to give, and has slower action so less side effects that the pills can have.
 
I had Cecil in a separate room last night because he was a bit unsteady on his feet and didn’t want him to hurt himself on the stairs. His glucose levels were fine I think he is just weak from not eating/adjusting to new meds etc. He was sedated on Thursday for his ultrasound as well so not sure if he is still recovering from that somewhat. He ate some more food over night and has just had a little bit more this morning too! I’m hoping he’ll have some more again before his vet appointment.
 
He ate a little bit more before his appointment! The vet gave some omeprazole for nausea and some more diuretics. She also agreed we should put his dose of steroids back up to 1/2 a tablet per day rather than every other day, as I noticed last night that we reduced his dosage on 5th and the first time he didn’t eat a meal was on 9th. We are seeing how he gets on over the weekend with the increased steroids, omeprazole and continuing with trying to reduce the fluid.
On the plus side his glucose levels have been pretty stable.
 
I am disappointed the vet gave you omeprazole (loser) instead of cerenia or ondansetron. I’m not sure how well that will work. I’ll be interested to hear. And I hope it does work. He didn’t give an appetite stimulant?
Did the vet change the steroid to budesonide?
 
I will keep you posted on how he does. I still have a dose of appetite stimulant I can give him later on today.
No we decided to try and stabilise on the prednisolone as we were able to control the diabetes whilst he was on it effectively and short term goal is just to get him eating and gaining some weight. If he seems brighter and starts to eat more significant amounts we will look at the other steroids. For info he has been on prednisolone for 2+ years and until recently when he became diabetic the steroids worked very well for him and his stomach issues were completely settled so I am reluctant to change it just yet whilst he is already so poorly
He has eaten a little bit again since coming home from the vet but not a huge amount
 
I understand why you are wanting to stay with the pred at the moment.:)
If the losec does not improve his desire to eat a lot, I would go back to the vet and ask for one of the other antinausea meds mentioned. Don’t wait too long in doing that as it is really very important he starts to eat well, otherwise you are going to run into other serious problems.
Have you tried any of the suggestions to stimulate the appetite or trying other foods apart from low carb? Of course these may not work if the nausea is not dealt with.
I’m keeping my fingers crossed he starts to eat for you.
 
He is interested when I bring food over and smells everything, he has been eating a little bit today but he seems to want to lick the sauce and isn’t keen on chewing the bits of meat, I’ve just blended up one of the pouches of food and he took that okay, maybe had about 1/3 of a pouch. He had a little bit of mousse earlier too so I think he might just be feeling a bit weak and finding it easier to lick food rather than chew. I’m happy he is eating a little bit of food but it’s hard at the same time every time he turns away from it but I know I just have to persevere.
Do you know how quickly anti-nausea medication should kick in? I forgot to ask at the vet so not sure how long to give the omeprazole to work?
 
I’m not sure about the omeprazole as it is not used often for cats here on the forum. But in humans it stops the acid in the tummy and I’m not sure how that would work in cats to stop nausea. I thought it was more for reflux.
Personally I would go back today and ask for one of the 2 antinausea meds mentioned above as that should work straight away. I don’t want to harp on about it but it is really important Cecil eats and it really does sound as if he is nauseated.
 
I'm concerned about the continued use of prednisolone with that HCM diagnosis. Was the HCM diagnosis done by a veterinary cardiologist? Neko could not have pred due to her heart condition. There is a possible pred side effect of steroid induced heart failure. Fluid in the abdomen being one symptom. Thankfully less common than steroid induced diabetes.

I second Bron's suggestion on a proper antinausea med. Both Cerenia and ondansetron can be given, they target different nausea receptors.
 
We have an appointment at 12.15 UK time so I can ask for the anti-nausea meds suggested above. If he starts to eat again I will speak to the vet at his next checkup about switching the steroids. We don’t have specialist vets near me just regular vets and my particular practice is quite small. The one we are going to today is a lot bigger
 
My baby boy passed away yesterday. The vet did offer all of the medication discussed but explained he was at the end of his life and it would just make him slightly more comfortable for perhaps a couple of days. I knew in my heart he had had enough and didn’t want to prolong his suffering. I’m heartbroken but I know I did everything I could. Thank you so much for your help and suppport
 
Oh I am so very sorry to hear this. You certainly did everything you could to help him. I know you are heartbroken, it is so hard to say goodbye to our beloved kitties.
Take care of yourself.
Fly free Cecil:rb_icon:cat_wings>o
 
Oh no, I am so sorry to hear this news. :bighug::bighug:. You made that hardest of decisions, doing what was best for him.
 
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