Going great for a month but suddenly stopped eating

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DodgersMom

DodgersMom

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Dodger was diagnosed with diabetes about a month ago. He also had ketones. He's on Lantus 0.5 unit every 12 hrs. He's been doing really well. He gained some weight back and is back to his old self. He had a followup vet appt last week and the fructosamine test was 231, which the vet was very happy with. She said it indicated good control and to keep doing what I'm doing. Followup appt in a few months.

This vet has not suggested any home testing. When I asked, she said we would discuss it after his fructosamine results, which she didn't. I get the impression they aren't in favor of it. I haven't pushed it but after recent events I may need to.

Dodger is still ravenously hungry, especially in the mornings. I'm only feeding him Fancy Feast pate, either turkey or chicken. I give him almost a whole can at mealtimes. This is the amount that satisfies him without wanting more. The remainder of the can I give him as a small snack just before bedtime. This keeps him from waking me up at night wanting food.

Yesterday evening he didn't want his Fancy Feast, which is very unusual. I managed to coax him to eat enough to give him his insulin. This morning he again just sniffed at it. I gave him a different brand of pate and he only picked at it. Since he ate so little, I did not give him his insulin this morning. Was this the right thing to do? What am I supposed to do if he won't eat?

When Dodger was first diagnosed, the vet initially suspected he had pancreatitis. I still have Cerenia and gabapentin from then. Wondering if I should try to give him some and see if it helps his appetite. Suggestions?

ETA: I've been wracking my brain trying to determine what caused this sudden change. OK, so the night before last, Dodger got into my purse during the night. He pulled out a baggie of Dot's Pretzels which I put in there to take to work. I found the bag on the kitchen table full of holes. I don't think he ate that many. He does this because he's part monkey and because he's ALWAYS hungry. Wondering if the seasoning triggered a pancreatitis attack? IF I can get him to eat a substantial amount of food, should I give him insulin mid-day? Or should I stick to the every 12 hrs schedule, which is currently 6 am and pm?
 
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Don’t give insulin mid-day. Since you skipped the am dose, wait until tonight. @Bron and Sheba (GA) i feel like the 1/2 unit is a low enough dose, she can continue administering if she gets him to eat even a small amount, wdyt?

The reason he’s always hungry is because his diabetes is unregulated. Diabetic cats can’t process the nutrientes in food efficiently so they eat but are ravenous still. How much does Dodger weigh? Minnie was 17 pounds and she would eat 3 cans of FF a day plus snacks. They also burn calories just by peeing since there’s sugar in their urine. I’d let him eat as much as he wants right now.
Without home testing and data, we can’t really give you dosing advice because we don’t know how he’s reacting to the current dose. 1/2 unit is a good starting dose and Lantus ia a great insulin for cats. You’re also feeding low carb food so you’re doing great already. Would you consider home testing regardless of what you vet thinks? The fructosamine test is used to diagnose but not really helpful after that since it gives you a 3 week average.
If he has pancreatitis, he could be nauseated so I’d try the Cerenia to see if it helps. Ondansetron also works for nausea and can be added in addition to Cerenia. Did they ever do the pancreatitis test to determine if he had it or not? IBD also has similar symptoms. I’d suggest you started testing for ketones if he continues not wanting to eat. When Minnie had an IBD flare up, I’d give her baby food and tuna and she would eat those even when she wasn’t really eating her regular food.

Here is a link helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help.
With a diabetic cat you need:
  • A low carb wet diet that is 10% carbs or under. Most of us use around 4-7% carbs
  • A suitable insulin such as Lantus or Prozinc which are long acting, more gentle insulins than the old insulins.
  • We recommend hometesting the blood glucose with a human meter…it is not necessary to use a pet meter which is expensive to run and is no better. It will keep your kitty safe and you will know how the dose is working for your kitty. Only testing every so often will not tell you what is happening in between those times and an awful lot can happen in even a day.
  • The HELP US HELP YOU has information about the spreadsheet, signature and hypo box which you will need to be able to look after your beloved kitty properly
We are happy to help you with setting up the spreadsheet, sorting out what food to buy, how to transition safely to a low carb diet, how to learn to home test and much more.
This is an excellent site for diabetic cats…it has been around for more than 25 years and has very experienced people to help you.

Keep asking lots of questions.
 
Could be pancreatitis if BG is reasonable
DodgersMom said:
He pulled out a baggie of Dot's Pretzels which I put in there to take to work. I found the bag on the kitchen table full of holes. I don't think he ate that many. He does this because he's part monkey and because he's ALWAYS hungry. Wondering if the seasoning triggered a pancreatitis attack?
Click to expand...
Could be.
My Murre did a very similar eating of dog treats, like 4 oz of them when he ripped bag open. I do not remember how long afterwards he developed pancreatitis.
 
Thanks Ale & Minnie. When you say to give him as much as he wants, does that mean per portion or throughout the day? I give him as much as he wants at mealtime and then a snack at bedtime. There's no one at home during the day to give him midday meals. I could leave a plate of wet food for him, I suppose. The vet told me to only feed him with the insulin injections, so I'm confused on this.

As for the pancreatitis, they tested him when this all started and it came back negative. The vet suspected IBD and wanted to put him on a steroid (starts with a B?). But I had just started him on insulin that same week and wanted to wait a bit. I had read that ketoacidosis can cause stomach pain, and since he did have ketones I thought that may be the case. The pain symptoms went away after starting the insulin and he was fine until yesterday. Maybe it was the pretzels.

I am definitely willing to do home testing without my vet's blessing. If I can get the supplies without a prescription...?

I looked at the spreadsheet and it was confusing to me. The only thing I could fill in is diagnosis date and type of insulin. Beyond that it looked Greek to me. Maybe if I start home testing it'll make more sense.

I have empty gel caps, and so I put some Cerenia and gabapentin in one and got it down his throat. Will get some odansetron. I offered chicken breast and treats - no interest. He's sleeping now so hoping he'll feel better when he wakes up. Will update later.
 
It was probably budesonide? That’s a good option since it’s a localized steroid that doesn’t typically affect the bg.

it’s old fashioned thinking that diabetic cats need to eat only x2 a day. That’s something that works for dogs who have lower metabolisms. Most of us feed the larger meals at shot time like you’re doing then smaller meals or treats throughout the day. It helps to avoid sugar spikes and it’s also easier on their pancreas. could you maybe leave out some dried freeze treats? A lot of members here who have a similar schedule use an auto feeder that will dispense the food at a certain time. You can add wet food to it and even some ice cubes to keep it fresh @Diane Tyler's Mom you use one right?

can you get some Gerber baby food today and try that? The ham flavor seems to be a favorite for most cats? I’d try tuna as well. If it comes to it, can you syringe feed? I’d be afraid of ketones if he is not eating and you’re having to skip the shots. You can get the urine test strips at any human pharmacy, see the info Red provided above.
 
You don’t need a prescription for the testing supplies. Most of us use human meters because the test strips are way cheaper. ReliOn from Walmart is a good one and you can get the meter, strips and lancets all from them.

we can help you setup the spreadsheet once you start testing :cat:
 
I have a sneaky feeling you're confusing IBD and pancreatitis. With IBD, cats tend to either vomit or have diarrhea or both. IBD is diagnosed often first with an ultrasound and if the results are suspect, by biopsy. The biopsy is the definitive test. It's generally treated with a steroid and diet change to novel proteins. Pancreatitis is a painful condition that can be diagnosed with a blood test -- either a Snap or Spec fPL. If they test too early or too late, you may get a false negative result on the fPL. Also, you need to be sure that the vet isn't using a lipase test -- it's unreliable in cats. Pancreatitis an inflammation that will eventually go away and the symptoms are what's treated. That said, it can become chronic and your cat will feel terrible during a flare. This is a link to our Primer on Pancreatitis.

I am not a big fan of recommending prescription medications unless you are certain what the underlying condition is. A cat may not eat because of nausea or because of pain. They are treated very differently. Either way, it will mean a vet visit.

I would encourage you to get a human meter and start home testing. Many people use use the Walmart Relion brand meter as the strips are inexpensive. It's very difficult to recommend any dose changes without seeing what Dodger's blood glucose numbers look like. You do not need a prescription to buy a glucometer or testing materials. You'll need a meter, strips, and lancets. You'll want to get 28 gauge lancets for the moment.

The spreadsheet is written in a bit of shorthand. AMPS and PMPS are your AM and PM pre-shot numbers -- the test results you get prior to giving an insulin shot. The "+" numbers indicate how many hours it is after you've given a shot. +1 is one hour after injection, +6 is six hours, etc. The "U" indicates the insulin dose (i.e., units of insulin). You don't need to worry about the rest of the information at the top of the spreadsheet for right now.
 
I'm not confusing the two. When I first took Dodger to the vet, she suspected he had pancreatitis, but the test was negative. The test used was the fPL or whatever it's called. She then suggested there could be an IBD element and wanted to put him on budesonide (thank you, couldn't remember the name.) I just never felt like IBD was his problem and was unwilling to put him on another med the same week as the insulin. Plus he never had the symptoms to support it. Pancreatitis seemed more likely. I may have mentioned in my first post that I was frustrated with the vets, regular and ER, and their contradictory opinions. Plus draining my bank account in the process.

I got some turkey baby food (out of ham) and also some ketone test strips. I'll be back later to see what I have to do with the strips. Right now I have to get him to eat something. Sorry, my stress level is high right now.
 
OK, got a little baby food and regular food in him, enough to give him insulin. He's fairly active, jumping on things, etc. Will keep trying to get him to eat more. I read the link on ketones. It said to put the dipstick in his urine. Dumb question: Does this mean under his urine stream or into the litter containing the urine?

My manners! I forgot to thank everyone for all your advice. I'm reading and taking notes. The stress comment was referring to lack of family support. So appreciative of all input! Will get the other testing supplies early next week.
 
Collect a urine sample if you can and dip the test strip into it and read exactly 15 seconds later. The colour keep changing so read at 15 seconds. Taking a photo of strip at 15 seconds is a good idea as well if you can. There should be no ketones.
With a history of ketones you don’t want to be skipping doses of insulin.
Also feed him all he wants. At the moment if he’s not eating, try any food at all. It’s very important he eats.
It is food and insulin that keeps ketones away in diabetic cats. Also make sure he is drinking well.
Feed him during the cycles as well as the Preshot meals. Have a look at automatic timed feeders to use while you are at work.
You may need to take him to the vet for antinausea medication.
Hometesting the BGs will be one of the best things you can do for him. We can help You set up a spreadsheet. keep asking lots of questions
 
Ale & Minnie (GA) said:
You can add wet food to it and even some ice cubes to keep it fresh @Diane Tyler's Mom you use one right?
Click to expand...
Hi I have never used one but a lot of members have used this one
I see a lot of members use this auto feeder comes with 2 ice packs for wet food
They also add some water to the food so it won't dry out

https://www.chewy.com/cat-mate-c500-digital-5-meal/dp/154556?utm_source=google-product&utm_medium=cpc&utm_campaign=hg&utm_content=Cat Mate&utm_term=&gclid=Cj0KCQjwmIuDBhDXARIsAFITC_63x-luggpCkFZRkS8gkKWhzRbyN2QiluSdQbUAVg-nyE2iitAjCY4aAjTmEALw_wcB


Extra ice packs
https://www.amazon.com/Mate-Replace...8EYNZ1RBTQP&psc=1&refRID=AQNY433XJ8EYNZ1RBTQP
of 5 stars Identical to original ice packs that came with my Cat Mate C500

If you don't like your kitty eating put of plastic you can get this for the feeder
https://www.amazon.com/Cat-Mate-Sta...at+mate+stainless+steel&qid=1678749693&sr=8-1
 
Dodger is much better. Appetite not where it was, but enough that I can give him insulin. The info in this thread has been really helpful. I'm re-reading and taking notes. Will get the BG testing supplies. I'll give him more small meals and never skip the insulin again. Haven't had a chance to test the ketones yet. I keep following him around hoping he'll go to the litter box, but so far he's evaded me.
 
Yes, gave him Cerenia & gabapentin yesterday. Just now I gave him another dose of Cerenia. I wrapped it in a pill pocket and hid it amongst his treats. I didn't mention this yesterday, but my other cat vomited yesterday, lost his appetite and slept most of the day. He's had bouts with pancreatitis in the past also. He's not as easy to fool, but I managed to get some Cerenia in him today also. Sigh...
 
Ale & Minnie (GA) said:
@Bron and Sheba (GA) did you see my question about the dose being so small that maybe there’s no need to skip even if he eats less than usual? And i believe she gave Cerenia yesterday. @DodgersMom can you confirm?
Click to expand...
With ketones at diagnosis we really don’t want you to be skipping doses if at all possible. So before skipping any dose, please post and ask for advice. Even if your kitty is not eating, you could give a 1/2 dose of insulin. Diabetic Cats that are fasting for surgery are given a 1/2 dose on the morning of the surgery.
With Lantus he doesn’t have to eat all the food before the dose. You have 2 hours before the onset of insulin so it is ok if he eats some of it after the dose…does that make sense?

Would you be able to set up the signature please so we can see details of Dodger.. also add he had ketones at diagnosis.
 
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