DKA Cat - when to feed after anesthesia? giving fluids

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Priss

Priss

Member Since 2012
Hi,

I ran out of insulin for about a week which was really stupid. My cat has only pooped once since then. Saturday I was able to get her insulin and restart it (1 unit of insulin twice a day) I called the vet for an appointment Satuday and they asked m to bring her in Sunday at noon. She has been eating up until Sunday morning when she wouldn't. The vet kept her for a few hours to hydrate her and ran a blood panel. They wanted to do a glucose and urinalysis also but I could only afford one thing and the blood panel covers the glucose and some of the same things in the urinalysis, it was $340 to run the panel and over the visit and hydration. After I picked her up yesterday I was able to get her to eat 1/4 cup of the prescription dry food (I don't usually feed her but just wanted her to eat) and gave her a unit of the insulin. All the vet told me to do was take her home and try to give her something yummy, then said not to give her the insulin. I asked even if she eats and the vet said to give it Sunday night but not the next morning. Well today she wouldn't eat this morning, and I called the vet at 1pm and 5 pm. They told me I would get a call when the vet had time and they usually call after close, and was told the panel results already came in. Well no one ever called me, they open at 7am tomorrow. The cat isn't eating still. I checked her blood glucose and it is at 203. She is drinking water but not eating and lethargic. She still hasn't pooped and the vet didn't seem worried about this. Only once in the last week and she's been eating the whole time up until yesterday. I haven't given her the insulin since she ate yesterday.

I don't know what to do, if I should wait until 7am tomorrow (830 pm here now) and call the vet or go to an emergency vet?
 
Re: Sick Cat

If you can, try anything to get her to eat, deli meat, boiled chicken, KFC, hamburger, some folks have had luck sprinkling parmesan cheese on cat food, baby food..etc.

Not enough insulin and not eating can lead to DKA. Do you have any ketostix??
 
Re: Sick Cat

I called a late night vet but the doctor had already left the vet tech said to try force feeding her. She won't eat anything,I tried lots of things, I managed to get her to eat a couple bites by putting the food on her paw and face like you would medicine. She's still drinking but very lethargic, laying about and getting up to lay down somewhere else, the vet opens at 7am and I'm calling them first thing in the morning. I didn't give her the insulin since she isn't eating and I thought it might compound it if she gets hypoglycemic. Shes peed in the box but I haven't seen her go since I came home from work. I don't have any ketostix
 
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Can you run to the store and get some ketostix? Not enough insulin+dehydration are two red flags for ketoacidosis. If ketones are present, then she needs to go the the Emergency vet right away.
 
Re: Sick Cat

She still hasn't pooped and the vet didn't seem worried about this. Only once in the last week and she's been eating the whole time up until yesterday
Click to expand...
If she is blocked up with stool, she will stop eating.
 
Re: Sick Cat

IMHO, You need to find another vet NOW and take sweet baby in - the vet not being concerned with the poop, urine output, etc doesn't have your baby's best interests at heart. Something needs to be done to help her right now. Thoughts and prayers from here for both of you.

If you're about to run out of insulin again and can't get more for days, PLEASE post here letting us know - maybe someone nearby can help or one of us can try to get some to tide you over.

BIG HUG,
 
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I called the vet when they opened at 7 this morning, the doctor got in at 8 but I got a response at 830, she did have high ketones and liver enzymes. I brought her in straight away and had her hospitalized. Its $700 and they said she may need two days, at the same cost, still no reason why they couldn't call me back yesterday. Cat could hardly stand when I brought her in. The vet called at noon and said they were taking care of her low electrolytes, and that she had a bladder infection and was resting. I just talked to them now and they want me to put her in another vet for just as much overnight, then bring her back again tomorrow for more treatment. She said I could take her home with fluids under the skin or leave her there overnight unattended, but then she said I can't really take her home alone since she needs to be monitored, I said to find out how much it costs for the 24 hour vet and also why they didn't call me back if they had the lab results yesterday. I don't know what to do about it. I don't really want to stay with the same vet but felt I had no option this morning. Now I think I need to get my priorities straight and focus on making sure I get the cat's medicine on time. Next time if someplace doesn't call me back I'll just drive there and wait in the front office until the cat gets taken care of. Of course I want to do everything I can to save her, I'm not going to just give up on her, can't think about what they do to other pets people can't afford to treat
 
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I'm finding out about the 24 hour vet, I think I might try and just keep her there. I don't really understand why the cat should have to change vets for night and day rather than stay in one 24 hour facility, is that normal?
 
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The vet put an underskin fluid dispensor in her and I'm feeding her with a syringe every two hours until tomorrow morning, when I'll bring her back to the vet for monitoring. She is a lot better now and moving around some, was really happy to come home.
 
Re: Sick Cat

What can I do to help. I'm in San Diego -- way up in the northern part. Where are you, and how is the kitty doing?
 
Re: Sick Cat

Dear Priss,

I've had a chance to look through all your posts, and understand what I can of your situation from what you have said. You MUST take your cat to ER right away. There is no way for you do deal with this at home. Someone tried that earlier this year, and we never heard what happened, but I think the cat died. I know it may seem Priss is doing better, but if the vet was handling an electrolyte problem, you must have someone with equipment you don't have taking care of your cat right now.

I agree with your idea to keep the cat at ER instead of going back to the vet in the morning. I am very disappointed that this vet tested for ketones, got a positive reading of "high," and ignored your calls all Monday night only telling you Tuesday morning that the cat was in need of ketoacidosis treatment. I would never, ever go back to that vet.

Maybe between me and the other San Diego person on here, we can get you a better vet later, but for now, your cat needs to be in ER. Please let me know you got this post. Thanks.
 
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Priss

I agree with Dale 150%. Ketones can get out of hand fast and diabetic ketoacidosis can be fatal. It is extremely are to treat at home. I would not move her to the first vet tomorrow...I'd leave her in the 24 hour hosptial...ask them if they have a critical care specialist. A cat throwing ketones needs insulin, food, and water.

It will be expensive. If you google Care Credit, you may be able to qualify for funds to help.

Good luck and please let us know how she goes.
 
Re: Sick Cat

I found a different ER tonight in another part of the county that can take her in for 24 hour care. Its extremely expensive and at the end of the exam they mentioned her prognosis was poor to guarded. Its an ER exam tonight and then she goes to the internal medicine department tomorrow morning after another consultation. Its 230am here and I have to go to work in a few hours. Its really the best I can do at this point. Thanks for your advice after considering it and reading online about the faster acting insulin at the vets, I didn't want to risk it. The ER vet suggested I could put her to sleep but I won't consider that. They want to keep her 48 hours, right now I could only cover 12 hours so tomorrow I will see what I can do. The exam took a few hours for the estimates and everything so I just wanted her to get care. After breaking down the cost per hour it was less than the other 24 hour vet recommended. This place thinks she may have liver problems and mentioned her test from Sunday had high liver levels. They will rerun the chem panel and also do an ultrasound tomorrow, for the two tests alone are $650. She looked a lot better tonight while at home. Hopefully she pulls through. All the other family cats we had never had any vet bills besides the usual vaccinations, it is a real difficult process taking care of the cat but there's no way I'm going to give up and put her to sleep especially after I already failed her in getting the medicine on time. Hopefully they take good care of her.
 
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Sending many prayers and healing vines for your sweet kitty. We've seen some pretty sick kitties here that were showing ketones and changes to liver values and they recovered. The liver values could reflect some hepatic lipodosis from her anorexia.

Please keep us posted.
 
Re: Sick Cat

I don't know much about fatty liver. My cat, Bob was treated for DKA.

Here's what I found as far as diagnosis of fatty liver:
A typical sequence in the diagnosis of this condition would be:
Cat is obviously sick and sees the vet.
Cat may show the yellow pigment changes typical of liver disease (70% of cats with lipidosis have jaundice.)
Routine blood tests show marked ALP elevations.
Bile acids are elevated (testing bile acids is not necessary if bilirubin is elevated).
Ultrasound shows a disease process involve the liver in its entirety.
A needle aspirate or tissue biopsy shows hepatic lipidosis.
Click to expand...

It sounds to me like they have gone through the first few steps and are now at the "ultrasound" step?

I think it comes down to how the fatty liver and DKA are treated.
I believe the treatment for fatty liver is "feeding", usually with a feeding tube. Once the tube is in place, this is something, I believe, that can be managed at home.
You can't treat DKA at home.

If I had to choose one or the other, I would say to concentrate the funds on the DKA treatment?

I hope someone who has dealt with both can offer some advice soon.

Carl
 
Re: Sick Cat

I'm sending the strongest get well vines I can to your cat, Priss. My cat survived DKA, and was hospitalized at a University Veterinary School in Philadelphia. It didn't turn out to be as expensive as you would think, but still expensive.

Hang in there. You are doing the best you can for your kitty. (((hugs))).
 
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When Gabby was diagnosed, she had pancreatitis and hepatic lipidosis. They do do an ultrasound to confirm both diagnoses. Treating DKA and HL is expensive. Gabby spent 3 days in the ER/ICU and 24-hour monitoring was critical. If electrolytes are out of balance, that kind of monitoring is absolutely necessary. What concerns me greatly is your regular vet's attitude.

I would ask the vets at the ER what they would do to treat the HL without the ultrasound. It may help your decision making to know if there are enough clinical signs and symptoms along with lab results that would support a presumptive diagnosis of HL. If there are and all the ultrasound will do is to confirm the diagnosis, would treating your cat based on all of the data exclusive of the ultrasound be a problem? I don't know that there's any specific medication they would give for the HL that could otherwise be harmful but that's an important question for you to ask. Generally, the issue is getting your cat to eat and making sure that the HL doesn't progress to liver failure.

I would follow up on the resources that Squeem linked above. DCIN can set-up a "chip-in" to help with expenses.
 
Re: Sick Cat

You are in great hands here re the DKA. There are cornerstones for treatment - enough insulin 1.5x`s the amount of food, and fluids and getting the infection treated. Did they do a culture and sensitivity of the bacteria?

I would assume you are dealing with Fatty Liver concurrently. Treatment for feline hepatic lipidosis FHL is lots of food - food is the cure for FHL, fluids, a liver support supplement (improves survivability) and antinausea medication.

A lot of vets don`t recognize nausea in cats. They force a chemical appetite stimulant mirtz or cypro to the mix and it compounds the issue. Ondansetron is the best antinausea medication for cats. Cerenia is good for acute vomiting but not nausea. Ondansetron can be found for 80 cents a pill from thrivingpets online.

Is your cat one that would be okay with assist feeding via syringe - if so you can avoid an etube/feeding tube. you have to get a lot of calories in though. MY CAPS LOCK IS STUCK ON - I HATE THIS LAPTOP SORRY - A CAT WITH FHL ALONE NEEDS TO MAINTAIN HIS/HER WEIGHT TO AVOID FURTHER LIVER DAMAGE. A CAT WITH DKA NEEDS TO HAVE 1.5XS THE MAINTENANCE CALORIES.

\Ok its off now.

Iams MaxCal is worth its weight in gold for a cat fighting DKA AND FHL. Its 330 calories a can and only 3-6% carbs. They may try and send you home with AD but this is about 170 calories a can. Ask for MaxCal instead.

There is a yahoo group dedicated to helping their owners assist feed. Can you join the Yahoo feline assisted feeding group - ]1when you register you will be sent five autofiles. one of them is a detailed outline of how to safely assist feed. here is a video of someone assist feeding their cats.

http://pets.groups.yahoo.com/group/Feline-Assisted-Feeding/

video: http://www.youtube.com/watch?v=U6o17wH6ujk
 
Re: Sick Cat

Hi everyone,

Thank you for your help - yesterday I believe she was already given mirtz and today the 24 hour vet gave her cerenia, pepcid, and symcodin (sp). I asked about possible liver medication and they will send me home with denamarin but right now say it needs to wait until she is more stable. Vet brought up homecare as syringe feeding, skin fluids at home after discharge, they do carry the maxgold. At this point we will go forward with the fluid/insulin therapy for another 24 hours and see how she does. Vet also says we can go ahead and treat the ppossible liver/pancreas issue with the feeding.

I know we can do the syringe feeding, we did twice last night before the ER with no issue.

Right now we are paid up with and have maxed out my care credit but a family member is going to apply and help for the next 24 hours of treatment.
 
Re: Sick Cat

Thank you so much for the updates!
If syringe feeding is advised, that's great news. Sub-q fluids aren't difficult either. No ketones is awesome news!
I think this is pretty encouraging news.

Will keep you and her in my thoughts and prayers,
Carl
 
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Hi, Elizabeth,

As you know, you posted your test results on this thread: http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=78089&p=843972#p843972, and I posted a little bit of information about what the various tests were for, but I don't know a whole lot. Hopefully someone else does.

I'm really happy to hear your cat has no more ketones!

I hope your visit with Priss was good, and eased your mind a bit. My thoughts are still with you.
 
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Hi Carl,

The vet suggested a feeding tube but now we are focusing on getting the fluid treatment and see her improvement, then we hope to take her home and syringe feed.
Luckily there is someone available at home to care for her at night, so we just have a few hours were someone can't monitor and feed her. She still seemed lethargic but I hope because we were visiting at her usual bedtime. Right now she has a guarded prognosis but last night it was poor/guarded. Thank you for thinking of us!

Elizabeth
 
Re: Sick Cat

Hi,

As of this morning the vet called and said that she is not doing much better. Last night they kept her on fluid therapy and regular insulin. Right now we can only afford to keep her on the fluid therapy until tomorrow morning assuming another half day is the cost of half a regular day. The vet says the ultrasound would tell us if there was a worse condition so we could make the decision to put her to sleep and stop treating. In my opinion I would rather put the money to trying to help her as long as we can than find out its not worth it. The vet is pushing an ultrasound and especially a feeding tube, she says they tried to syringe feed her and she retched. I asked if there was vomiting and she said no but that they hardly got any food into her. Does anyone have any experience with syringe feeding? It sounds to me if she is not vomiting we should be able to do this.
 
Re: Sick Cat

Priss

Go back up into your post and PM Karrie and Maverick, she is one of the most experienced with this type of thing.

Terri
 
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It is my understanding, and this a layperson's opinion with NO experience with this sort of thing, that if she does not get food she will not recover. If you can afford the feeding tube maybe you should go with that instead of the ultrasound because if you spend all your money on the ultrasound and find that her liver is okay, you will not be able to afford the feeding tube to save her? Once it is in place, as long as she's stable enough to go home, you can feed her at home through the tube. There are youtube videos on how to do it.

I would ask the vet if you can take her home if she has the feeding tube, and explain that you will have to foregoing x number of hours at the ER if you pay for the feeding tube, and will have to forego the feeding tube if you do the ultrasound (if that's true), and forgo x number of hours in ER! Ask them to help you spend your money wisely; they should be willing to at least give you the information you need to make these decisions, if at all possible to make them.
 
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I agree with Dale....the feeding tube...and you want an etube not a peg tube ....is the way to go. You can get alot more calories in her that way and cat's adjust well to it. I don't think you will be able to get enough calories in her by syringe feeding if she is sick.

Sending more healing vines.
 
Re: Sick Cat

As I said Karrie`s cat Maverick had a feeding tube that saved his life. So I think Dale might be right. Sending prayers your way.

Terri
 
Re: Sick Cat

If you can't feed enough calories by syringe/finger feeding a feeding tube is a life saver. The yahoo group has a lot of great info and we can support you through this.

DO NOT GET A PEG TUBE! Make sure its an etube. Also MAKE SURE THEY DO NOT PUT THE TUBE DIRECTLY INTO THE STOMACH. Make sure they do a post placement xray. We are finding on the FAF group a lot of vets are placing the tube directly into the stomach and we aren't sure why.

The end-tip of the E-tube should end about 1 inch above the lower esophageal
-sphincter-, that is about 1" above the stomach. If you join FAF let me know - I'll link to the post that discusses tube placement.

A saline insertion/coughing test doesn't confirm placement.

It is overwhelming - hang in there and stay strong.

I would not do an ultrasound. I would use the money for a feeding tube. Maverick's story is in my signature. Garland and Tawny both survived DKA and FHL with the assistance of feeding tubes. You can read their posts on FDMB. I can send you links to FAF success stories too to give your heart a boost. Maverick is not an official one but he was as close to dying as he could get and he pulled through. He was not diabetic at the time though. But had we listened to our vet he would have died. The FAF group saved him. I try and pay it forward now - helping others who were once in that tough spot I was.

Sending big hugs.
 
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Also prepare the following:
1. Cerenia if he/she is vomiting. Food only helps if it is kept down. So you can get a prescription and get it if you need it. This way you can save some money and only fill it if vomiting occurs.
2. Ondansetron. This is a must. Don't leave the vets without a script for this. A couple scripts would be even better. You can get it at a decent price at Costco without being a member. But Thrivingpets online sells it for 80 cents a pill. A dose is 1/4 of a 4mg pill twice a day. Don't tell the vet this. The plumbs guide says up to a 4mg dose, so you can get more medication this way if you ever need it. A lot of vets do not recognize nausea in cats. This can be gagging, teeth grinding, lip licking/lip smacking and in Maverick's case showing interest in food but just licking/smelling and walking away.
3. MaxCAL food. 330 calories a can. Worth its weight in gold to get you through the crisis. After the crisis is averted you can switch to say wellness chicken which is 200 calories a can. I hear in the USA if you have a prescription for this from your vet you can get it at Petsmart.
4. A liver supplement - denamarin is great but can't be crushed. If she is hard to pill - go with marin which can be crushed.
5. Learn to do fluids at home. I believe Marjorie has helped others learn how to do this before. I have never done fluids as Maverick was not diabetic at the time of his illness.

Do not:
1. Use an appetite stimulant. There is times for this. If a cat is eating but just not enough for example. Giving an appetite stimulant like Mirtz. to an anorexic cat would be like giving you one with an all out flu. You know that nauseated feeling and being chemically forced to eat can backfire. A lot of cats have long term food aversions or won't even eat with the stimulant.
2. Metoclopromide/reglan only works on cats who's nausea is due to low stomach motility. Not on general overall nausea. It works on dogs but not cats. If a cat is vomiting food or partially digested food hours after eating - this could be stomach motility issues. Food should have been moved through the stomach by then.

Regarding the feeding tube - it would be great if you join the FAF site. This way there are a lot of people ready to jump in with tube advice. And always keep both groups up to date. The FAF group are not diabetes experts. I have a new puppy so my time online is a bit spotty - I'm falling asleep reading websites LOL.

If you get a tube, order a kitty kollar. It will make her feel a lot better. Maybe Tawny's mom can share hers with you. You don't have to go back to the vet to be charged for bandage changes. There are pictures on the FAF website.

I'll try and find my tube crash course that I posted to Tawny and Garlands mom.

Remember to keep your feet on the ground and breathe. Your vet does not know your cat. You do. Vets are not God's in white coats. If anything we have learned that we know more on these groups than they do. Trust your heart.

Maverick was with me another 2.5 years after recovering from FHL. Every day I'd think wow, you are still with me. I had 2.5 wonderful cuddle filled years that I will treasure forever. I wouldn't have had them if I listened to our vet. He got fired by me eventually.
 
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We're leaving to go the vets to see if we can syringe feed her ourselves. I know they have been giving her the appetite stimulants - both Tuesday and today at the two different vets. Monday night she ate from the syringe, so we hope she will, if not we will try and find a way to get the feeding tube. The 24 hour vet suggested we try to find a regular vet which it may be less. I think like Dale mentioned, she might not be getting better since there is no food for her.
 
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Some cats like constraint but most cats don't. So when you do try and syringe feed her, make sure she is calm and its a good experience. Give her a cc at a time. Then pet her and brush her, tell her how beautiful she is. Heck even sing to her. What ever makes her feel safe and secure. Most cats can handle 35ccs of food/water. All meat babyfood is good for starting syringe feeding. Stop if you see her stomach lurching. Really really really push for the ondansetron. They can give her the sister medication - dolasetron at the vets also.
 
Re: Sick Cat

The first vet which didn't call us back and the emergency vet spoke to each other. The emergency vet told us the first vet is offering to place the feeding tube for virtually no charge. I'm waiting to hear back from them now. Do you think we should try syringe first or go straight to the tube?
 
Re: Sick Cat

Go with what your gut tells you. Most cats recovering from DKA and FHL do so with feeding tubes. It is easier to get food and medicine in. You will probably only need it for a couple weeks. Make sure they have experience placing tubes and don't place it into the stomach itself. With a tube you can feed her when you need her to eat - to help manage the DKA recovery better. She will need a lot of food and calories.

You have lots of people here to help you.
 
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I think I'd go with the tube as soon as possible. She's got to get food in her in the most efficient manner possible as soon as possible.

Carl
 
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I'm trying to read through all of these posts and figure out what is going on so please take my advice with a grain of salt because I'm still a bit confused trying to read all of the posts.

My cat Gus has triad disease (pancreatitis, IBD/IBS, diabetes). He developed hipatic lipsidosis last year. After about $7000 I will tell you my mistakes and what I learned really worked for him. What worked: buprenex, plasma transfusion, subq fluids and changing foods.

Ursodiol made him worse and made him stop eating again.

Milk thistle liquid (alcohol free) seemed to be better than denamarian. All of these can cause stomach upset so be careful. Gus's body couldn't dissolve the denamarian so the liquid Milk Thistle was the best for him.

Cerenia - yes! Good medication. Long term it made Gus feel bad, but for a day or two it was great.

Injectable Pepcid - yes! Great for stomach upset, but the buprenex really worked better long term than this.

In the end Buprenex has been our savior. It gets rid of the pain quickly and Gus could eat.

FOOD - I wish I had known, but Gus had developed an aversion to artificial flavors over time and Fancy Feast was a huge culprit in all of this. Once I figured that out it was a lot of trial and error to find a food that didn't make him sick or cause him pain. We are on Purina DM, Nature's Variety Instinct, and Avoderm Chicken.

Syringe feeding didn't work and I did it everyday. Gus needed to eat on his own. However - this works for many cats, but they need to have something to get them through whatever pain is making them not eat.

My vet's office has cats that they have put a feeding tube in even though they never figured out the cause. The cats get through whatever it is and they are better. You can get a lot of tests and no answers. Even with answers - the treatments are still the same. Why waste the money?

The above experience is my own personal one with my cat and how his body works.

If you need to call me - PM me for my number. I had someone from Canada helping me and she would call me and talk to me for hours helping me through all of the treatments. I don't mind paying it forward because it is hard to know what to do. I don't have all the answers, just a few.
 
Re: Sick Cat

You should keep advice on the board especially when it comes to a cat dealing with DKA. by keeping advice on the board there are many eyes making sure treatment advice is accurate and recommended. Mistakes can and do happen even typos can cause a lot of issues.

Not sure about the buprenorphine which is a very strong pain medication. I don't know if she has a diagnosis yet that suggests this would be helpful. Maybe I've missed something. Lots to take in on this thread.

This board is like no other I've found on the web with people's generosity and support. I am so lucky I found it when Maverick was diagnosed.
 
Re: Sick Cat

My suggestion for her contacting me directly is mostly for support and if she needed any further explanation of what I have posted. I have stated over and over my experience is personal to my cat and may not work for anyone else.

As for buprenex - it is prescription only so she couldn't get it unless her vet approves it. All of the treatments - aside from denamarien and milk thistle require prescriptions.
 
Re: Sick Cat

Hi everyone,

thank you so much for all of your advice. What happened is she was discharged from the ER hospital and we brought her back to the regular clinic. They are doing the feeding tube for free and it is the esophagus tube not the one in the stomach. There will be an xray afterwards also for placement. The medications the ER hospital sent us home with are:

Cyproheptadine appetite stimulant
zenequin
famotidine
denamarin
cerenia
metroclopramide syrup
taurine
l-carnitine
LRS

she seems perkier and now has licked a small bit of babyfood and scratched at the nurses. She swiped us when the tech was showing how to give the fluids, also.
So, we will pick her up later today. Hopefully she makes it through the surgery alright, I had to sign an anesthesiology release form for it. Once she eats again I'll try changing the food. We had her on the fancy feast but she isn't really enthused about it. Same with Wellness
 
Re: Sick Cat

The possible other diseases they suggested are primary liver disease and pancreatitis, with uncertain prognosis. I am hoping it is will reverse with food like most of you have mentioned. Keeping our fingers crossed, to see how it goes!
 
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Do not give the cypro. Focus on assist feeding. And most vets dose this way too high - 1/8th of a pill is lots. Never give cypro or mirtz without being totally sure nausea is under control.

Nausea hasn't been addressed. cerenia is for vomiting and metoclopromide doesnt work in cats unless stomach motility is an issue. here is a technical article: http://veterinarycalendar.dvm360.com/avhc/content/printContentPopup.jsp?id=676860

Liver issues are horribly nauseating. Watch for signs of nausea - stomach lurching, teeth grinding, lip licking, lip smacking and showing interest in food and just licking and sniffing and walking away. I'll post on your FAF post with a link to our nausea file so you can read this for more information. The important thing is keeping food down, but if nausea is unadressed (if you see signs of it) that means its an overall quality issue. Remember how you feel with the flu - you may not be vomiting but feeling nausea is just as bad.

Great news about your vet. I'll post more about the etube as well.
 
Re: Sick Cat

Here is the crash course I posted for another member:

Crash course for you:
1. Do not do a preflush. That takes up space that food can and isn't needed. Do a good post flush of 8mls of water after feeding and medication.
2. Go slowly - 1/2 to 1cc at a time and give a break of 30 seconds or more in between.
3. Use warmed up food. You can prefill syringes in advance and put them tip down in warm water before each feeding to warm them up. Cold food can make vomiting and nausea worse.
4. If kitty bolts while being tube fed drop the syringe! You won't be able to hold kitty back by holding the syringe and can pull out the tube.
5. Most cats can only handle up to 40ccs of volume. You will most likely need to fit in a night time feeding or two the first week. Food is medicine here along with insulin. And you need a lot more food than a healthy cat would.
6. axCal is worth its weight in gold. 330 calories a can. AD is not high enough in calories for a \DKA cat. You have to feed 1.5xs the normal amount of calories with DKA recovery. Its only 3% carbs. Wellness Chicken is 2-4% carbs and 200 calories a can. There are other foods higher than this. Blend the heck out of it, add some warm water and then strain in a fine metal sieve to get any gritty bits out. You need 1.5xs the amount of calories normally eaten. Straining the food prevents a lot of stress. A clog is preventable.
7. Have coca-cola on hand - not diet or pepsi - to clear tube blockages. Instructions on the FAF site for doing this if you need it.
8. Don't put sticky meds down the tube. I believe the carnitine is really syrupy. This will easily clog the tube.
9. Buy a kittykollar from www.kittykollar.com. Much more comfortable and easy to change dressings. Until you get a kitty kollar you can put the elastic end of a mens tube/sport sock around the bandages to give kitty something to scratch and reduce the risk of them catching a nail on the tube and pulling it out.
10. Most important - - don't race kitty to eating on its own. You have the tube, use it. Kitty will eat when he is feeling better. And don't race to remove the tube. Too many people do this. Relapses are common in an unregulated cat and the tube is a safety net. Your cat will adjust so well to the tube he won't even know he has one. Wait at least one week, preferably two before removing.
11. Actually the biggest most important thing is to not give an appetite stimulant to a tube fed cat. No mirtzipine or cypro. You can cause long term food aversion issues. Watch for signs of nausea - lip licking, lip smacking, teeth grinding, showing interest in food but licking or sniffing and walking away. Most cats with feeding tubes have underlying issues like DKA, pancreatitis or feline hepatic lipidosis and need an antinausea medication - ondansetron, dolasetron, anzemet and cerenia (used for acute vomiting). Reglan/metoclopromide and pepcid AC are not antinausea medications. Pepcid can help with excess stomach acid though.

Denamarin shouldn't be crushed. If you can't give orally you can give twice the amount of denamarin through the tube.

Keep your feet on the ground. The first week is emotional and exhausting but worth every second. It gets easier. You have lots of support here and on FAF.
 
Re: Sick Cat

Hey Priss, just to let you know, my cat J.D. came home from the hospital from DKA with a feeding tube. It was a bit messy for me, but it saved his life.

Also, I believe I purchased Ondansetron from Costco for $25. for 75 pills, or something like that. I would try to ask your vet for a prescription for Ondansetron to be called in for you.

Hang in there. I'm pulling for you.
 
Re: Sick Cat

The vet gave us some gauze suqares soaked in a cleaner. It leaked on the bag of medicine and fluids needles. Do you think this is a problem or should they still be OK to use? I'm asking because the needles have the paper seals wet through in some places by the cleaner.
 
Re: Sick Cat

Hi,

I'm a little confused as to when to feed after the tube is placed. At discharge we were told 4-6 hours afterwards when the anethesia wore off. Now it was mentioned to wait until morning to be sure she wasn't groggy, and just give fluids tonight. She hasn't had real food since Sunday. We came home with two cans of Hills L/D and a prescription for the Max Cal. Were told to wait until morning for medications also. It is the etube and I checked on the assistance feeding group which mentioned it can be used right away.

ELizabeth
 
Re: Sick Cat

Hi, Elizabeth,

I would call the ER and ask them these questions on your last two posts until you can get an answer here. Do you think they will be helpful?

I'm not sure by the wording of your post who told you to wait until morning? The ER or a website's info or both? Of course, I have no idea, and I don't mean to imply that you should do either one, but this seems like a very important issue for fatty liver treatment, and waiting until morning if you weren't supposed to might be a very bad idea. On the other hand, if she's groggy, it may be dangerous to feed her too early even if 6 hours have passed.

Carl? Can you help?
 
Re: Sick Cat

Hi Elizabeth,
Dale, I just sent a PM to Karrie. I think she was on a few minutes ago but may have missed the update and the questions.

Elizabeth, I've never had to deal with a feeding tube but I'll keep trying to contact someone who can answer your questions.

Carl
 
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