Hank- Back from vet... Evening Update more barf

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bettyandhank

bettyandhank

Member Since 2010
It is late. I am just figuring out something is not right with Hank. He has not been eating normally for a few days..but seemed he was being finicky (so I thought) He would eat but just a few bites, walk away,...lots of food left in bowl as I opened different ones..some of which was eaten but there are 2 cats.
He has seemed a bit quiet but nothing glaring. I did start wondering more in the last day observing...thought maybe his tooth hurt. It almost seemed like when he ate it was startling a little..then he walked off. He is interested in eating but something wasn't working.
He has sipped on water here and there..also not typical (he gets his water in his food) but it was just a few sips a time or two. Today I boiled chicken which they love. Elvis went nuts walked in circles for more..Hank did not come to the kitchen. I took a a small piece to him and he ate it..but did not come to kitchen for more. Tonight I tried first some chicken breast he ate only 1 small bite of...then warmed a food I know he likes..added FD chicken dust on top..he ate readily, got a few bites in then threw up near the bowls. I followed him where he had gone in the bedroom..now showing classic nausea signs..licking lips incessantly..but seems otherwise alert, clear eyes, not sick seeming. I sat on ground with him and he was heaving some, then more throw up..but almost no food mostly foam this time and lots of it. Then once more a few minutes later, pretty much foamy liquid. Poor thing. So I decided to weigh and test him. He ALWAYS jumps on his test spot when he hears the zipper on the case..tonight he did not come. I tested his BG at 113. This is HIGH FOR US. Has been 100 or more only 2 other times in 4 years of remission that I know of, the last was around time of his dental when his whole mouth was terribly infected. I weighed him and he has lost almost 3 lbs since December!!!!!! OMG! How did that happen? He was a little heavy so he is not skinny..but that is too much to have lost that quickly.
So that is back story. Something is wrong. WHAT DO I DO RIGHT NOW? He seems hungry..he wants to eat but apparently makes him sick. I have Zantac 75 (Ranitidine) but no pepcid. Is that ok to give? I do not have cerenia. I feel he is hungry. He wanted the FD chicken after the BG test- but walked away after one- this NEVER happens- that's crack to him. I have a can of Royal Canin recovery, I have some bupe left from his dental surgery. What can I do RIGHT NOW for him..and overall what do I need to do??? I can't know if this weight loss is all from the recent period or possible that it has been coming off over the last 3 months. But now that I am clear something is off..I know it has been going at least a few days or more. I was out of the house much of the last 1 1/2 weeks or so...he may have responded with stress. This BG is of concern..I will keep an eye on it. I do not have any insulin. Should I try to feed him or not..and what? Should I give any of these meds? Hope someone sees this.
 
Re: Need help- anyone awake?

Betty

Sorry to just see this now and not earlier. Clear,foamy liquid is a sign of stomach acid. Yes, you can give him Zantac 75.

The usual dose is 0.25 to 1.00 mg per pound (0.5 - 2.00 mg per kg) every 8-12 hours, though most people find twice a day is fine.

I'd give him that and wait 30 minutes and see if he wants to eat anything. Do you have any baby food in the house that does not have anything but meat and water....like Beechnut? It is ok also to give him some Recovery. Will he let you syringe him?

Does he seem to be in pain? Is he meatloafing (which can be pain or acid tummy)? If you palate his abdomen, does he growl or act like it is tender? If so or if he acts like he's in pain, give him a dose of bupe. Is he lethargic and, if so, how long has he been?

Although a lot of info on this Tanya's page on Nausea, Vomiting, and Stomach Acid applies to cats with chronic kidney disease, you might find some helpful.

Has he been drinking and peeing a lot? Does he seem dehydrated? Test by rubbing your fingers over his gums...they should be slick. Or lift his scruff and let go..it should pop back into place quickly.

There are several things that could be going on. He could have some Pancreatitis although I would think his BG would be much, much higher. He could also have some renal issues but you would notice him drinking and peeing a lot.

I think my goal tonight would be to stop the acid, treat the pain if he seems in pain, try to get some food/water in him, and call the vet first thing tomorrow.
 
Re: Need help- anyone awake?

I sure wish I could tell you what to do, but I don't feel I can. I know what I would do...don't worry about insulin because, while his numbers may be higher than his normal, they're still in a normal range for a nondiabetic cat. Keep an eye on him as best you can overnight and take him straight away to the vet tomorrow. If you can afford it, you could take him to a 24-hour vet tonight. I know it's awful when your baby doesn't feel well and you just don't know what to do. I wish I could stay up with you, but I have to be up at 4 a.m. for work and I'm heading off to bed. Hang in there and let us know what happens!

Yay!!! So glad Marje is here for you!! She's the brain in this organization!!
 
Re: Need help- anyone awake?

Marje. I am typing this from bed w/ 1 finger on tablet so short answers to some of the questions. Of course I suspected pancreatitis but its not something he's ever had before. By the time I got my original message posted and came down he was already by his bowl..he WANTS food..he's hungry..that's why its so hard to see. I opened fancy feast and he went for it...but threw up within moments. The frothy stuff earlier was because he had already thrown all the food up. He is heaving and barfing. Amounts are not huge since he is barely eating. Last round was also liquidy but not foamy. So you think his BG would need to be higher to indicate Pancreatitis?....well that's a good thing. No matter the reference ranges this IS high for him. Highest in 4 years. ..at least that I've caught...I'm glad its not higher but its worrisome. RE: zantac- That formula confuses me .25-1.per is too broad. Tonight he weighed 13.5 lbs. How much of 1 zantac 75 pill should I give him? He is not meatloafing. He is being very quiet....and wants to be real close.. is right by me now sleeping....did not check for tenderness but picked him up earlier which he usually hates..no crying but the weight loss is palpable. I have got to get food down him. He is asleep now and I won't wake him..I have never syringde fed him. But the issue is not appetite...he's tried to eat...he just walks away after a few bites because its making him sick. I gotta get him some sustenance. Dehydrated?..possibly..can't tell for sure....I pulled the skin on his ruff but he is lying down so hard to tell, maybe. I guess if he is not eating his food he is also missing out on the water that is mixed in it...that would add up over several days so perhaps he is. What else can it be if not Panc? Why has he suddenly loss 3 lbs? Lethargic?....quiet mainly...... No obvious pain, no growling so no bupe for now. Water bowl is freshened...not sure if he drank any. Remember he had 'pre' kidney indicators, In his labs in September...but we decided nothing yet to be concerned about. Could it have progressed in this short time? Now that I have typed y'all are all asleep and so is he. I guess I will see how he seems in AM and decide if vet seems needed...maybe Let me know how to split the zantac and if we do go to the vet can you come with us please :cool:
 
Re: Need help- anyone awake?

That foamy throw up is also a sign of dehydration. I watched it happen many, many times with my little Jomo. Whenever she threw up foam I knew that I needed to get her sub-q's very fast, and then get her to the vet for IV fluids. In fact, for my Jomo, if she was at the point of throwing up foam I would nearly always have to take her to the vet for IV fluids for at least 3 days. Sometimes she would also throw up maybe about a teaspoon of a clear liquid, as you described.

That is my experience with foamy throw up. A classic symptom of dehydration. BTW, cats will not eat if they are dehydrated. Dehydration does make them sick to their stomach.

It's so easy for cats to get dehydrated and it happens so fast. Just turn up your heater when you get cold, and if your cat is sleeping anywhere that is nice and toasty warm, say on a polyester blanket, for example, I found that can lead to dehydration PDQ.

I rarely use that skin pull test at the scruff of the neck any more to check for dehydration. To me, if the cat's skin/fur lifts and stays up, then it is already too late for me to try get my cat rehydrated at home using sub-qs.. It means I had better get my kitty to the vet to get her re-hydrated using the IV drip because the electrolytes go directly into the vein using that method. When Jomo was dehydrated I found that I could NEVER get enough fluids into her using sub-qs at home to get her body properly in balance again.

For me, I find that putting my finger on the cat's gum is a better way to see if the cat is dehydrated. If the inside on the gum is not all slimy wet, it means dehydration, even if it is just a little bit sticky. Usually the cats mouth is very wet on the gums just like humans. Your finger would slide and glide right across it. If the gum is dry to the touch at all, that is dehydration. Also, if the cat's gums are more of a white-ish pink color rather than a healthy pink color, that is dehydration.
 
Re: Need help- anyone awake?

Betty,

Please if you are reading this please take Hank to the vet, it sounds most likely that he does have pancreatitis. Please refer back to Marje`s post on the Primer she wrote. Things can get bad very quick with this, If you have read most recently what Jennifer went through with Cain and this is just how it started with her. So please take Hank to the vet, this is nothing to mess with. My cat Lilly(GA) had pancreatitis twice.
The test is Spec fPL for pancreatitis.

Terri
 
Re: Need help- anyone awake?

I agree with Terri. There can be any number of things you can do at home but if this were my cat, I'd want the input from my vet. We can't see Hank nor do we know how to give him a thorough exam. Getting bloodwork, including a test for pancreatitis (Spec fPL or Snap fPL) will help to rule in or rule out the diagnosis.
 
Re: Need help- anyone awake?

Betty

I hope you are at the vet with Hank. I waited for you to come back for about an hour because I wanted to see if he was dehydrated and if you had some fluids you could give him.

While one would "expect" the BG to be higher with pancreatitis, Cains were not at first. When he first stopped eating and vomiting, they were a little higher but not in the yellow/pink range although within a couple days, they were.

And yes, renal values can progress quickly. So without bloodwork, we won't know what the issue is. He is likely not eating because the smell of the food makes him nauseous. That together with the weight loss, makes me wonder about his kidneys. If his phosphorus has gone up, it can make him very nauseous. If it weren't for the weight loss, I'd be thinking of something more acute.

But whatever it is, he needs to see a vet today and, if he were my cat, if I couldn't get him into see my regular vet, I'd go to the ER.

Sending prayers and vines. Please keep us posted when you can.
 
Re: Need help- anyone awake?

Hi Betty,
I hope you are taking Hank to the vet this morning. The Snap fPL can be done "in house" if the vet has the IDEXX equipment. It will tell you if Hank does or does not have pancreatitis, but will not tell you how mild or severe it is. For that you must have the Spec fPL, which must be sent to IDEXX labs.

We are sending lots of healing vines to Hank and will be looking for your updates.

Hugs,

Ella & Rusty
 
Re: Need help- anyone awake?

Thanks for the replies. Was a late night but he had fallen asleep and seemed comfortable so didn't try/do anything else. He got more sleep than me....woke up to sound of him trying to barf (all this on bdrm. carpet of course) but it was teensie amnt. since no food...unless maybe he had gotten up to eat some of what was left from last night.... Anyway...I brought him some water and he took a couple sips. Then went to make coffee and he stood right there in his spot waiting for brkfst as usual. I opened a fresh can...always his fave...and he ate readily but only a small amnt. did not finish. ....normally he is a hoover. But he did keep this down. He wanted to be right by me...so I loved on him then shortly after opened the Recovery and he was interested and ate a few bites of it too. All in all still probably less than an oz. collectively BUT he has kept it all down. So I feel better he has some sustenance, few sips of water and now curled up sleeping by me...problem is I can't sit here all day even though he would like me to. I tried to wipe across his gums to check dehydration and was not definitive to me. Was suprised to see how yellow-brownish teeth looked so soon after dental. Anyway cannot clearly tell if he's dehydrated..its not obvious. I am watching and will try more food and check BG when he wakes up. I have read about Pancreatitis plenty on threads in past including the primer ...and aware of sorts of things people do IF that is it. We don't know and Marje thinks his BG would likely be higher.... But we have never done any of these things personally. I have never given fluids...or B-12, cerenia, etc. So if we end up at vet on short notice I am not going to have time to read back through all that. Specifically what do I ask for there. If we get cerenia. is it injectable...are there delivery options? What do we want? Same w/ b-12? How do I ask him to prescribe? This vet charged a fortune for bupe..we spent over $200 on just that in the course of his pre/post dental care. So may see if we can fill anything he needs elsewhere and need to know how to ask for it. Same for fluids....does anything need a RX? I know many of you give fluids all the time but I never have and will be Nervous Nellie if necessary to do this. I have no one here to help. Does it matter if I get snap vs spec? At this point he is resting and seems comfortable so not positive we will call... But I will be watching and ready.
 
Re: Need help- anyone awake?

The Snap test is done in the office an it gives you a "+" or "-" -- kind of like a pregnancy test. The Spec is sent out to a lab and you get a value.

You need prescriptions for bupe (it's a narcotic) and for fluids and probably the set up for fluids. Marje or others can tell you more about the specifics for fluids.
 
Re: Need help- anyone awake?

Thanks Ella you must of replied while I was typing...and thanks Cheryl too. I know about bupe. Its the cerenia, b-12 and fluids I need to figure out (potentially)... This place is expensive and I am really strapped..just going will be a stretch...thinking ahead if there are options
 
Re: Need help- anyone awake?

How much of 1 zantac 75 do I give?....he was appx. 13.5 lbs last night. (16.5 in Dec)
 
Re: Need help- anyone awake?

Betty

I'm sorry but I'm out the door to a doctors appt. I really want to urge you to take him to the vet. Hepatic lipidosis can onset by even a reduction of 50% or more in calories over a few days. Then you start getting into some huge expenses. You could read back over the last few days of Cain's condos to see how quickly he progressed from not eating and vomiting to FHL to not recovering. I don't mean to panic you but I would get him to a vet.

Again, I'm not saying his BG will be way up there with pancreatitis and I would never use that as a dx tool. I'm saying one would think it would be higher but ECID.

You could start on the low end of the Zantac if you want and see how it helps. If you go to the vet,they will likely give him a shot of cerenia. I'd get a prescription for that(cerenia 16 mg) and ondansetron 4 mg. You can order them through thrivingpets,com. But the better way is to get the injectable if your vet has them and will dispense them to you. You don't want to have to worry if you can keep pills down him.

But...I don't think it's a good idea to just treat blindly. I think you need a dx. If this is renal related, the treatments might need to be different.
 
Re: Need help- anyone awake?

ok. He is asleep still..I am showered. Marje thanks..I know you are rushed out the door. I am not going to give Zantac til I figure out what the correct amounts are. If we get an appt. I am not sure when it will be. Maybe check back on the other side of your appt...and hopefully if I need to figure out something quick when we are there someone will be around.

thanks!
 
Re: Need help- anyone awake?

Betty,

Please take him to the vet. I lost one cat to Pancreatitis and one five days late to Hepatic Lipidosis. It could be neither of these things, it could be altogether something else but you don`t want to get into tonight and have another episode and have him get worse.

Terri
 
Take your cat to the vet, better yet, the ER

Hi Betty,

It does sound like pancreatitis, and dehydration is a classic symptom of that. We all think that it would be best if you get him to an ER animal hospital right away. The main reason I would rather see you take your cat to the ER for animals now is because they would start him immediately on the IV fluids.

And if he were my cat, I would have him stay at the hospital 24/7 for a minimum of 3 full 24 hour days, where they would administer the IV fluids and whatever else the vet orders continuously.

Like I said earlier, I found that once my little Jomo, (who suffered from chronic pancreatitis), was vomiting foam and only little bits of fluid, I knew that I could not give her enough sub-qs myself at home to get her body in balance again. If I did not take her to the vet and tried to re-hydrate her myself what I found was that she *might* eat part of a meal for me, and then she would throw that up, sometimes many hours later, with any of the water that she drank. Of course I couldn't give her more sub-qs then because her body had not processed the fluids that I had already given to her.

The continuous IV drip is most likely what he needs at this point. You've already mentioned a few times that your cat is "sipping" water. He probably cannot get enough electrolyte fluids into his body to make his pancreas function as normal, again.

I also had a kitty, Emma, with Kidney Disease. I had to give her sub-qs towards the end of her life. What I found is that the sub-qs can maintain a cat with Kidney Disease because you give them every other day, every day, or 2x a day, or whatever schedule that you and your vet have worked out. Anyway, the Kidney Disease cat is ALWAYS on a schedule for needing fluids.

This is not the same in a pancreatic cat. You must treat the cat with pancreatitis within the first 12 to 24 hours of developing the symptoms or you are at risk of your cat developing Fatty Liver Disease. The treatment plan for pancreatitis is to FIRST get the cat re-hydrated to ensure that the cat's pancreas is delivering enough blood through the organ's cells to make it function correctly; the cat is given pain meds (in the hospital Buprenor administered through the IV is THE best one, make sure that your vet is giving it to your cat); the cat is sometimes given a drug to make them feel less like vomiting, and sometimes given a drug to increase their appetite; and the cat of course needs nutritional support because it is not eating on it's own or not eating enough calories to maintain or gain weight.
 
Re: Need help- anyone awake?

Personally, I would like to see the vet's recommendations prior to making any statements about hospitalization or anything else. We're guessing. No one here is a vet. The opinions are just that -- one person's opinion and the input of a veterinary professional is critically important.

FWIW, several of our kitties have been dealing with a GI "flu." It could be something as simple as that. Or maybe it's something more complicated. I doubt that any of us would walk into our physician's office and ask to be hospitalized for 3 days, tell the MD that we need fluids and how much, and what drugs to prescribe based on what other people who have never seen you have suggested. Any physician that took those recommendations seriously certainly wouldn't be my doctor. You need lab values even to know that everything is fine.

In case people haven't read this sticky note, it's a classic: Suggestions for Advice Givers. I don't trust "Dr. Google" and I don't go by WebMD or internet sites alone. Look at the research and be very aware that as much reading as you do, whether it's internet sites or research/journal articles, unless you have data (e.g., lab work) or are exceedingly familiar with a condition, you are diagnosing in the dark and that's dangerous. For example, telling someone to give fluids if the cat has an undiagnosed cardiac condition could jeopardize the cat's safety. You need to have a broader picture. A dear friend of mine is an MD/PhD and one of the smartest people I know. He recognizes that many people here have developed a great deal of expertise with feline diabetes and some of the related conditions. He observed that the expertise is great -- but it's one disorder. Diabetics can develop a number of unrelated conditions and since that's not what we concentrate on, we can miss an unrelated or even a related problem.

Betty -- please get Hank seen by your vet. I'd push hard for an appointment even if it means that the office is squeezing you in.
 
Re: Need help- anyone awake?

Betty:

I just want to add my voice to those urging you to take your kitty to the vet ASAP. I did exactly what you are doing last year with my kitty, Kisa. He was not diabetic, but was a picky eater, so it took me several days to realize that something was not right. I still hesitated, trying different things to get him to eat, assuming he was constipated, etc. By the time I did take him in, he had lost almost 30% of his body weight (he was very furry, so you wouldn't know by looking at him) and was in big trouble. We went to great lengths to save him, including a feeding tube, but it was in vain. If I had only taken him in when I first noticed he wasn't eating, he would be here today. PLEASE take your kitty to the vet!!!! I'll be praying for you and I hope you will take this to heart.
 
Re: - anyone awake? - vetty appt. set

Thanks for your concern and all the great advice everyone. I am taking him in as suggested and out of caution though he seems relatively comfortable at the moment. I will hear what he says and not jump ahead. I've been calling around to see if any of the most likely prescribed meds (anti-nauseals, etc..) are things I can get at pharmacies. Am really strapped and trying to lessen costs so will be good if there are other options.

Our appt. is at 3:30. Stay tuned. Not sure if they have wifi but will take my tablet in case so i can reach out if any questions.


thanks!!!!!!!!! :YMHUG: :YMHUG: :YMHUG:
 
Re: Need help- anyone awake?

Dear Sienna and Betty,

I am sorry for stating that everyone here thinks that your cat should be taken to the ER right away. I guess I am the only one that thinks this way given that you said your cat has already lost 3 pounds, is vomiting foam and small amounts of clear liquid, is "sipping" water, and he won't eat enough on his own.

In addition, I just wanted to mention that I did not suggest that YOU give your cat fluids. It is my opinion only, and I am not a vet, but based on what you shared I think he is most likely dehydrated and needs IV fluid therapy.

As far as getting lab work done for your cat-- OF COURSE!! That is a no brainer, and your vet OR the ER would want to do lab work on your cat, so I did not mention it.

I am sharing my personal experience with everyone here that I had with my pancreatic kitty, Jomo. Her vet told me that I was "one great cat nurse," but I know that means nothing to any of you here.

Of course, it's always up to you, Betty, as to whether you take your cat to your regular vet, or to the ER. For me with Jomo, I already knew that she had chronic pancreatitis, so for us, Jomo was always started on the IV fluids ASAP when she presented with the exact same symptoms that you have shared with us here. I knew that waiting to get her IV fluids to "see how she does," even a few hours would set her recovery time way back, cause me tremendous heartache and worry, as well as cost me a whole lot of extra money. :roll:

I think for most people here, but I do not really know, that their cat's personal vet cannot administer IV fluids, 24/7, which really is what is required when a cat is having an acute pancreatic attack. However, we do not know what is wrong with your cat. (But the symptoms you wrote about are classic signs of dehydration)

I was lucky with my Jomo in that her vet allowed her to stay overnight at their clinic WITH the IV fluids for many, many days, whenever she needed it. I don't think that most other vet offices can do this. I think most vet offices will treat acute pancreatitis the only way that they can: Administer A LOT of sub-q fluids in their office, (which when administered this way takes WAY longer for the cat's body to utilize); give your cat some medicine to keep it from vomiting; give your cat a vitamin B-12 shot (which they pee out of their system within a day); and give your cat something to hopefully increase it's appetite. A lot of vets will not even suggest or offer any pain medication for a cat with pancreatitis. That is why I suggested that you ask for it, *if* your cat has pancreatitis.

The reason only I suggest taking your cat to the ER right now instead of to your regular vet is because I never successfully treated my little Jomo at home for an acute pancreatic attack with just 'at home' sub-qs, pain meds, and syringe feeding, as a vet might prescribe/recommend. We tried that method one time, and within two days it did not work and Jomo was in the hospital for her longest stay ever. My little Jomo always had to be on the IV fluids once she vomited that foam, and small amounts of fluid. It was always her first sign that was having a pancreatitic attack.

BTW, in my experience a cat does not vomit foam if it is trying to cough up a hairball. Foam is always dehydration.

As far as "Dr. Google," yes, I have used him, very successfully too!! My Daphne and Digger became very sick when they were just small, not even one year old yet. They stopped eating, their bodies became limp, like rags, and they were sleeping all of the time. The vets at the clinic where I was taking them thought for certain that they had Leukemia and that there was nothing that they could for them. They tested Daphne, Digger, and even my cat Tsering, three different times with three different tests for FeLV and FIV. Those tests were always negative. Nearly $3000.00 later in lab testing, the vets told me that they did not believe those negative test results. They still believed that my cats had Leukemia. But I was not about to give up on my sweethearts.

Then my Daphne started to develop severe anemia and she was having labored breathing. I thought I was going to lose her. The vet's still did not know what disease my cats had but it was for certain that they were all going to die if they did not get the correct diagnosis and the correct treatment right away.

Finally, I got online and did some research. I found that their symptoms sounded a lot like Bartonella. I asked the vet, (the vet did not suggest it to me) to please run a Bartonella test on Daphne as she was suffering the worst. They ran an in-house test for Bartonella and it came back negative. I asked them right away to please run the test for Bartonella again, but this time with a specific company. They sent it, they did so. DAPHNE'S TEST CAME BACK HIGHLY POSITIVE FOR BARTONELLA. Daphne, Digger, and Tsering were all put on Doxycycline for 3 months. All three cats were healed of Bartonella.



Also, my own Rocky now that I am seeking help with here on this board, who has diabetes, had two lab tests that came back NEGATIVE for ringworm. But guess what? Rocky has ringworm VERY BAD and has been on an oral anti-fungal medication since about the middle of January 2014. Four different vets at two different hospitals did not even diagnosis it correctly by examining him. How was it determined that he has ringworm? I GOT RINGWORM FROM HANDLING ROCKY, SPECIFICALLY HIS EARS, because of all of the poking I have done to them for monitoring his blood glucose. I went to my regular doctor when I developed a rash. My doctor did a skin scratch test on my hands and examined it under a microscope. It was positively ringworm.

So, you can't always completely trust lab result. You must combine them with your own personal observations of your cat.

Just as with a child you must be your cat's best advocate, is what I found. I don't have any problem telling my vet what treatments I want for my cat based on the online research that I have done. If the vet thinks that they don't need the treatment I certainly listen as to "why," but I am not afraid to ask for what I've researched and learned will work for some cats.

Betty, I also pray for the return of good health of your kitty. A spiritual boost can also help work miracles. o:-)
 

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Re: Need help- anyone awake? vet appt. set

The typical anti-nausea meds that many of us use are either ondansatron or Cerenia. I know the ondansatron tablets can be expensive. However, if your vet is willing to give you a vial of the injectible form, it's cheap -- I just paid $18 for a vial. It's given as a subcutaneous injection just like insulin. You may want a bigger syringe, though. Your vet should be able to supply the syringes. I don't know the cost on the Cerenia.
 
Re: Need help- anyone awake? vet appt. set

Back from vet. Here is what he thinks, said, did...

He examined him and did not sense pain when palpating his belly or elsewhere. He was not alarmed by the BG number (117- out the door test today following last nights 113) Said his eyes looked a little sunken indicating perhaps slight dehydration, but his skin and gum check did not indicate if to be alarming at all..I think he said it was mild. There was no yellowing or concern re: hepatic lipidosis. He did not think fluids were needed at this point, both because it was slight if there was dehydration and because he thinks these suggestions for treatment are premature until we know what is causing them. He wants to find the problem not just treat symptoms. He said his symptoms COULD indicate Pancreatitis but also could be any number of other things. He asked if he could have possibly ingested something he shouldn't ie: string, etc.. and perhaps there was an obstruction? His suggestion was to do x-rays first to rule that out instead of randomly treating what might be. He is running bloodwork which will also give an updated look at the renal health status- since we recently discovered some early stage deficiencies. I agreed to the Spec fPl. We discussed cost which is a big factor, it just is..we are not ok. He is sensitive to it. But they are just really expensive- but so is everyone in Austin..some of the highest anywhere. He said the x-rays are first and what he would do with his own cat.
So he calls me back to see them, said organs look good, there was belly fat, he could see a poop almost ready to come out, then this one area he said appears bloated with trapped gas- and possibly a foreign object but may be just some stuck food or a really stubborn hairball that has been stuck. He said it has worked it's way through multiple feet of intestines at that point and now in lower area so almost out. this could cause these symptoms. He also decided to see what the rest of the lab results are before ordering the fPl...partly for cost. He said the fPl is expensive and if the other results indicate something else then we may not need it. He said the fPl takes several days to get back anyway so we can wait to decide tomorrow once we see the rest and one day won't matter. He gave Hank a Cerenia injection and wanted me to wait one hour for it to settle before feeding him. I am to watch tonight to see if he eats AND keeps it down. We talk in the morning for results.

Damage so far: $334.03 WITH the $47.50 discount he gave waving the exam fee. This doe NOT include the fPl which will add another $130-140. OR any meds we may need once we figure it out. So is this a $500 stuck hairball?????????

$47.50 exam
$160.50 radiograph abdomen (2 views)
$123.31 vet screen/CBC (limited panel)
$50.22 10mg cerenia injection ****!
-$47.50 (courtesy discount)

It has been one hour now that we are home and this is typed..so I will see if Hank is now ready for food since his nausea may now be gone. I forgot to ask about the Zantac doseage. maybe we won't need it.

PS: Tina hope I didn't say anything that made you feel bad or unappreciated. I am grateful for everyone's input. Having all the different perspectives helps especially from those who have been there. That is why this board is so awesome..the collective knowledge and wisdom of all us crazy cat ladies. Hard to think straight when its your own kitty. I didn't get to read your whole comment back as I was just walking in but will. But always chime in. I learn so much all the time here from so many. Hank and I are forever grateful as always to have this place to come...and that you care about us.
 
Re: Hank- Back from vet

my fingers are crossed for a hairball!

your vet sounds very good. and it sounds like the x-ray is telling quite a bit of good information, so as expensive as it was i think it sounds worthwhile.

you don't have any flowers where he could get to them, do you? daffodils are bad for cats. someone a few days ago was saying their kitty had eaten some.

we had great luck with the cerenia - i hope it helps Hank too.
 
Re: Hank- Back from vet

Update:
when we first got back seemed Hank might have wanted food but we were supposed to wait an hour for the cerenia to settle so I'd lifted the bowls. I brought him upstairs w/ me to preoccupy him and about 6:30 which would have been nearly 1 3/4 hours post shot I invited him to come down to eat. He didn't budge...was relaxing on the landing...not interested. I figured the cerenia kicked in and he would be really hungry by then since appetite has not been the issue. I was back and forth with him having several opportunities to come down and finally he did around 8pm....3+ hr's since shot. I gave him a small amount of core canned, warmed.....maybe 1/2- 3/4 oz w/ water mixed in. He was a little trepedateous but then was eating pretty good. I went to my desk to note times, etc on computer....away maybe 5-10 minutes. Came down and he was lying on bed...went to check bowls and found more barf in kitchen..fresh. Still food left in bowl..so he barely got some down and it didn't stay down even after a $50___-ing dollar shot!!!!!! Aaargh! SO NOW WHAT??? Poor thing..he has to be so hungry. He is laying on top of me now....quiet, still, resting. Still can't keep food down. It didn't help. What to do?
 
just thinking on the possible ingested things....
how about dental floss? or rubber bands? any plant at all? things that kitties might eat if they find it.


Adding appy vines/and not puking vines.....
 
Hey Rhiannon! Wouldn't that have shown on the xray? Thanks for the vines..we need them...definitely not in the clear. Need him to be able to eat. Glad we are hearing from vet in the morning. ..not as expected tonight
 
Cerenia is better for nausea than vomiting. Ondansatron is the better choice for vomiting (plus nausea). FWIW, I just bought a vial of injectible ondansatron from my vet. It was $18 for a whole vial. My guys needed a couple of shots to get them back to feeling better. (Ondansatron tablets are expensive. If cost is a concern, the shots are much less costly and since they are subcutaneous, just like insulin, it's something you can do.) One shot of the Cerenia may not be sufficient.
 
whoops!....thought i lost the post...OK sienne...odenestran was mentioned but I will mention it again. But nothing costs $18 there. This was at his recommendation pending lab results but not w/ the expected outcome. ...and $50. & even more worried now w/ another day of almost no food.... BTW I found odanestron at this generics-only pharmacy for a fraction of the other places. They don't carry injectables, only pills, but do have the dissolvable ones. Hank is asleep on me still
 
Is he still vomiting clear or white foam?

From Tanyas Guide to CRF:
Vomiting White Foam
Vomiting does not just include food - the classic symptom of excess stomach acid is to vomit clear or white foam.
Click to expand...

Here's the info on dehydration:
Recently sunken eyes may indicate dehydration, as may vomiting. Cracked paw pads are also occasionally seen, and litter may stick to the cat's paws. Sometimes a cat with dehydration hangs his/her head over the waterbowl, though more commonly that is a sign of excess stomach acid. The cat may also grind his/her teeth, or lip his/her lips.
Click to expand...

Cerenia is usually pretty effective against vomiting. It does concern me that he is still vomiting after the cerenia. A caution against using cerenia and ondansetron is in the case of a possible obstruction.
 
hi marje..no foam really tonight like last night. Just the couple bites he tried to eat at 8pm-ish came right back up w/ the liquid that was mixed in...just soupy puke. He can't keep food down. I found all kinds of other little spots of barf when we got in late today I i hadn't seen...I guess from yesterday...out of the way or small so didn't catch them. Didn't try feeding again until after 11pm as he was sleeping on me. he did come in kitchen and showed some interest. I warmed some FF and offered to him. He was hesitant...took a lick or 2 then left. I really sense that he would eat if it weren't making him sick. It does not seem to be an appetite issue. I know about the sunken eyes as the vet also mentioned ...but again with our discussion on the topic he was not alarmed, gave impression it was only slight and fluids not warranted at this time. Yes its a quandary if there is obstruction to be giving meds to facilitate eating, not sure if it would be counter to anti- nausuel,...but maybe it would?... It did not work anyway... (expensive experiment) Wonder if that indicates stronger likelihood of being obstructed? But we x-rayed..don't know what else to do. Its too long without enough sustenance....getting worried. Food is there if he can eat....just not sure he can. What are you recommending at this point? Will be anxious to get his labs in the morning and will post when I do.
Ella thanks for the visit, hugs & vines...we need it. Hank is asleep on me and probably for the night. I sure hope he can rest. :YMHUG:
 
Betty

I'd be concerned about how long he's gone without substantial food and the possibility of hepatic lipidosis. If he sleeps all night, then I'd either be talking to my vet in the morning or I'd be at another vet....maybe an internal med specialist. I know $$ are tight but obstructions are serious and if it is t an obstruction, they need to find out what is causing it.

If he wakes up and gets sick again tonight, IMHO and if he were mine, I'd take him to an ER. Have you ever applied for Care Credit?

Sending many prayers.
 
if he's not perked up and eating by morning, i'd give the vet a call and ask for advice.

sending our best wishes to feel better to hank! hope you can sleep some!
 
Hi Betty,

If Hank was my cat I would not ignore the suggestion that Hank is even 'slightly' dehydrated. Sunken eyes means only slight dehydration? :shock: I am not a vet but I do not believe that Hank can rehydrate himself by only drinking water when he is vomiting. The water wouldn't provide his body with electrolytes.

It is also interesting to me that this vet did not suggest to you the possibility that the large mass in his colon, the one about ready to come out, is a SUPER DRY HARD POOP that cannot come out because of Hank's'slight' dehydration :?: :?:

When my pancreatic kitty Jomo was alive I had only three other cats and I was able to monitor her health extremely close. One of the things that happened before she would have the foam vomit is that she would make frequent trips to the litter box and have no bowel moments. I would follow her to her litter box. Jomo seemed like she thought she was going poop, but nothing was coming out. Then she would go pee and cover it up. It was a lot more frequent trips then her normal routine to the litter box, so she was peeing more frequently, but not peeing large volumes of urine. She was losing more fluids with all the peeing.

So, Jomo had dried pieces of poop in her colon too. When they finally did come out, if they did come out without a vet visit, after a lot of squeezing effort on her part, they would be as hard as a rock and about the size of a few small pebbles. And that was ONLY after I gave her sub-q fluids for a few days.

If I saw this start to happen to Jomo then I could get the sub-qs out and give them to her myself and *sometimes* successfully beat a full blown pancreatic attack by giving them to her 2x a day. (I am not giving any instructions here, I'm telling you what worked for Jomo and under what circumstance they worked to help her, with the guidance and suggestions of my vet.) I also ALWAYS had the oral Buprenor on hand so I would give that to her immediately, squirt that along her gum line, every eight hours at first. This is what I would do if she still had her appetite and was still eating good.

If it had already progressed to a worse stage then Jomo would go to the water bowl more frequently and drink tons of water. She would also act as if she wanted to eat, but then she couldn't eat. She would come into the kitchen crying and crying for food and I would feed her. She would sniff at the food, take maybe two bites, and then walk away. She would look like she was going to vomit. About two hours later she would come crying to me again that she was still hungry, reminding me that she had not eaten yet. I would try to feed her again, and then she would not eat, again. I always had several different types of food on hand and would offer her so many different flavors. (She always preferred the pates and maybe it was because she was toothless.) Sometimes she would try to eat her food anyway, and then she would vomit it up, with just a smidgen of water, not very long after she had eaten. Sometimes if she had drank a lot of water she would vomit up all of the water she had drank.

Then the next level is when the foam vomit would start, not very much at first.

So, I would open up a jar of Stage 1 Baby food, either chicken and gravy, or turkey with gravy, and mix 2 tablespoons of it together with one tablespoon of water. I would heat it up in the microwave to make it smell good. I first would set it in front of her on a flat plate to see if she would lick it up on her own. If not I'd pick it up and then feed it to her with a syringe. Unfortunately, this Stage One meat baby food has very few calories in it and will not sustain a cat for very long. For us the baby food feeding was always only a one day event, a last ditch effort with the fluids and the pain medication to see if we could get her back on track to eating her regular food again. If she didn't want to eat her normal food (that I always mixed with water) within 24 hours or less, it was into the carrier and off to the vet for IV fluids and IV narcotics for pain we would go.

Jomo was never tested over and over for pancreatitis every time this happened. We all knew what was happening and the vet techs would just take her from me when I entered the clinic and get her started on the fluids and meds.

This is only my experience with Jomo, not advise.
 
I will be hearing from the vet in the morning with our b/w results. We only just left there after 5pm today. I thought the cerenia would offer relief as did he. The labs should tell where to go from here. Xrays were done for purpose of ruling/in out obstruction. I will speak to him in the AM and I believe I touched on all these points in our visit but will re-itterate. It is a somewhat new relationship with this vet but believe he is quite capable and so far like him and his team much better than all the vets we have gone to in the past. He is very up to date and really cares. And he includes you and is not all ego. We had gone to some of the 'best in town' prior and after several bad experiences around time of hanks FD DX and would not return. Obviously I am the most concerned and anxious to get to the bottom of this. It was only last night I even determined something wasn't right. I love him more than anything in the world....he is my baby, my soul kitty. I want him well.
 
Hi there Betty,

So, I think I read your post correctly, is it that you did not order a test to determine if Hank has pancreatitis because it is too expensive? And, is the reason that the vet is taking other tests to rule out other causes that might be making Hank feel so rotten?
 
(((Betty))) (((Hank)))) just getting caught up on Hank. So sorry to hear what is going on. Scrabble had a similar bout for two days where he was vomiting/diarrhea etc and took him to vets, they thought obstruction too. Ran tests etc and it was a hairball for him. He puked up the biggest hairball I had ever seen. Then he was back to normal. No idea if that is the case with Hank but hope you find answers in the morning. Prayers and vines!
 
(((Betty))) Hope you get some answers today about what is going on with Hank. And I hope it is something that is easily fixable and your boy starts to feel better. Mega get well vines for Hank cat_pet_icon cat_pet_icon
 
Please make sure to tell the vet that Hank was vomiting last night. I know it's an obvious comment but in the grand scheme of things, it could get overlooked and it's an important piece of data.
 
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