? HELP got back from a night away and Mimi hasn't eaten all day and her ketones are 1.1 pancreatitis??

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Mimis mom, Aug 24, 2020.

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  1. Mimis mom

    Mimis mom Well-Known Member

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    What do I do!??!??!
     
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  2. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

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    Is this reading from a blood ketones meter? If so, you're still below the danger line (around 2.4, may depend on the meter type).

    But, you do need to get her eating again. She may just be out of sorts with you going away, so offer her some snuggles along with food. Try singing, so she doesn't pick up on your stress, hopefully that is all that it is...
     
  3. Mimis mom

    Mimis mom Well-Known Member

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    I know and I was only gone 24 hours :( how will I ever go away for More than that? :(
     
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  4. Critter Mom

    Critter Mom Well-Known Member

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    Ketones ... :nailbiting:

    How is Mimi drinking? Can you get Mimi to drink more? it would help flush out the ketones.


    Mogs
    .
     
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  5. Critter Mom

    Critter Mom Well-Known Member

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    Also, is Mimi showing any signs of nausea? See this list:

    Nausea - Symptom Checklist

    Did your vet prescribe any anti-nausea and appy stimulant meds for Mimi? Do you have any left? And when did she last poop?


    Mogs
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  6. Mimis mom

    Mimis mom Well-Known Member

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    Ok so I got her to eat some turkey and sardines- she ate a good amount I would say-‘I also injected water down her throat. As far as poop-‘I don’t know I haven’t checked the litter box yet since I’ve gotten back from being away for like only 24 hours (had a pet sitter and was the first time I’ve been away from her since her diagnosis in August or last year.)
    I don’t have anything left over from her DKA last year. How should I approach a vet in asking for stuff so I can try and treat it myself a little? I got a stupid 8000$ vet bill last year and I’ve been reading people can do a lot of what they do themselves- also they don’t know nearly as much about the condition as this board does and it’s so frustrating and sad
     
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  7. Mimis mom

    Mimis mom Well-Known Member

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    Gave Mimi more turkey slices- she ate them - I’m hoping she’ll eat her regular food at +2, etc- so if she is eating then she’s not nauseous- which is a sign of pancreatitis?
    her ketones are 1.0 now-‘not sure how much better that is but at least it’s lower?
    Those ketone meters are ridiculous- they have to have just the right amount of blood- which is a lot to begin with and you have to put it in at the right time- it’s so easy to get an error message for 2$ a damn strip
     
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  8. Critter Mom

    Critter Mom Well-Known Member

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    Very glad to hear Mimi's eaten something. Do you sit with her while she's eating? Sometimes kitties find that reassuring and eat better with the bit of company.

    Here are some helpful resources:

    Persuading Your Cat to Eat

    Suggestions for Stimulating Appetite

    FWIW, DKA really does need hospitalisation because the kitties need aggressive insulin treatment (supported by IV sugars), fluid therapy and also a great deal of medical intervention to restore the metabolism to normal balance. It's a real biggie: DKA cats need intensive care.

    During post-DKA convalescence, it makes a huge difference if the caregiver has a supply of supportive meds at home so that any remaining nausea and appetite issues can be addressed on the spot (far easier to keep a cat eating - even a nauseated one - than trying to kick start the appetite completely). Having the right treatments immediately to hand is the best way to prevent relapses.

    I'd suggest keeping a brief daily log of Mimi's food intake, strength of appetite, and any symptoms of nausea (see the symptom checklist linked above for a guide). If you can present evidence of nausea and appetite issues to the vet then that might help you to secure an Rx for supportive meds to be used as needed. Elsewhere in the linked page about nausea above there are comprehensive details of commonly prescribed anti-nausea and appetite stimulant meds.

    When assisting fluid intake, be sure to syringe the water gradually, going from side to side of Mimi's mouth rather than from front to back, so as to ensure that she doesn't accidentally aspirate any water into her lungs.

    Sometimes adding homemade plain chicken broth or water from a can of tuna to the water in its bowl water can encourage a cat to drink more. Some cats like water fountains. I heavily water down the sauce from Sheba Classic cat soup for my civvie, and it has really helped to increase her fluid intake. (See the Persuading Your Cat to Eat linked page for similar products.)

    I'd suggest doing blood ketone tests a couple of times a day at the moment until they clear.


    Mogs
    .
     
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  9. Critter Mom

    Critter Mom Well-Known Member

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    Cheaper than a trip to the ER! ;) In seriousness, the strips are a bit on the steep side.

    I have a Freestyle Optium Neo. I found it as easy to use as a normal glucometer. I don't know which meter you're using, but if it's a bit of a pig to use then it might work out cheaper to get a different one: it would probably quickly pay for itself if it meant you weren't going through strips at rate of knots.

    I'm glad to hear Mimi's eating for you tonight, and doubly glad that ketone numbers are going in the right direction.

    Nausea can be a clinical sign of a number of conditions, including pancreatitis, DKA, and CKD. If Mimi's eating OK now then it's unlikely she's feeling queasy. Also, if a cat is constipated then that can lead to it not wanting to eat, or even result in it vomiting (usually when it tries to poop but can't), hence my litter box question earlier.


    Mogs
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    Last edited: Aug 24, 2020
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  10. Mimis mom

    Mimis mom Well-Known Member

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    I think she’s pooping ok- She’s been eating sardines and this other food I have that’s from a can but she was being picky to her raw formula all of a sudden.

    I don’t have any left over meds- it’s been a year since she last had pancreatitis maybe she’s “due” again?
    Do they test of pancreatitis or is it symptom based? I don’t have a vet I love either.. :(
     
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  11. Critter Mom

    Critter Mom Well-Known Member

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    Hiya!

    Two tests for pancreatitis are available:

    * Snap fPL - vet should be able to take a blood sample and run this on the spot. Gives a yes/no result (bit like a home pregnancy test). A positive result indicates inflammation of the pancreas is present but gives no indication of severity. It should be all the vet needs to initiate treatment.

    * Spec fPL - blood sample needs to be sent out to a lab. It gives a numerical result. The higher the number above the upper limit of the reference range, the greater the degree of pancreatic inflammation.

    Here's a very helpful resource:

    IDEXX Guidelines for Treatment of Pancreatitis

    Includes details of all supportive meds, pain relief, etc., etc. Fingers and paws crossed you'll never ever have any use for the above, other than to increase your own general knowledge. ;)

    That doesn't help. :banghead: Been there. :bighug:

    How is Mimi doing overall today? Energy and activity levels, mood, etc.?

    There can be variation in quality and content between batches of the same brand/variety. Do you have any more portions of the raw food with a different batch number?


    Mogs
    .
     
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  12. Mimis mom

    Mimis mom Well-Known Member

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    Last edited: Aug 25, 2020
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  13. Mimis mom

    Mimis mom Well-Known Member

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    So her energy levels seem to be ok- it’s also hard to tell with her because she’s a very mellow cat - she did start “attacking” a hanging cord as if it was a mouses tail or something- which is a good sign lol
    She slurped all of the sardine juice from a can and ate some of this canned formula I have that is low carb (but more of a 7 than a 1 which is what her raw is)
    She’s cuddling currently with her brother Batman and licking his ears.
    she seems ok- I just worry she could have a start of pancreatitis.

    I called the closest vet she saw when she first got diagnosed (they use vetsulin as their main defense to treat diabetes which I think is odd..)
    They have an appointment today but they said because of her age they want to do a full senior blood panel as well- which is more money than I can afford right now- I mean I will pay it if it’s necessary- but she did just have a full work up on May when she got her teeth cleaned...

    Her last ketone check was at 9:30 am today and it was .9
     
  14. Critter Mom

    Critter Mom Well-Known Member

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    Maybe drain off some of the sardine juice and dilute it down a good bit with water. Might help you to get more fluids into Mimi to help flush out the ketones. Very glad to hear that levels are going in the right direction (anti-jinx!).
    Would the vets not accept copies of the May bloodwork? It's only 3 months since it was done. Are there any other vets nearby who use more up-to-date FD treatments? If yes, they might also be more switched on with things pancreatic in general.


    Mogs
    .
     
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  15. Mimis mom

    Mimis mom Well-Known Member

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    See this is why I hate vets sometimes-
    I’m being forced a fructosamine Which is $100 even though I told him (New vet) I have enough recordings of her blood sugar over the last several weeks and to please help keep her bill low and he’s telling me “I’m not going to work with you if you’re not going to trust me”
    Then saying testing for ketones is unnecessary- that it’s only going to drive me nuts that the only time I should test her ketones is it she’s not eating and her BG is in the 400-600 range. He’s not concerned with them at this time because she eating a little more and her BG is in the 200s (which makes some sense but jeez)
    Also saying that he needs a new blood profile, that the one from 3 months ago isn’t going to work for him even though I really just want to know if they can test for pancreatitis - like why does the other stuff matter right now?. He sounds a little arrogant - I only spoke with him on the phone because of no contact covid (which I’m sure the vets are loving because they probably hate when we come in with our animals to try and direct the visit-we are the ones with our pets every single day after all) I understand there are “know it all’s” out there but why don’t you check this website out first before you pass judgement! I’m sure if I had a visit with Dr Lisa Pierson from catinfo.org she wouldn’t be treating me this way!
    I appreciate that he’s assertive but I also think this particular practice is all about nickel and diming people..

    So senior blood panel, with pancreatitis check, stupid FRUCTOSAMINE, office visit, and he’s recommending giving her a dose of fluids subq with a Cerina ( I think it’s called?) shot for possible nausea- 475$

    So the only tests I don’t agree with are the fructosamine and the blood panel which cost about 300$ of that 475$
    I never leave the vet anymore without the bill being almost 500$ minimum- it’s insane.


    @Marje and Gracie

    @Wendy&Neko

    @Sienne and Gabby (GA)

    what do you guys think as well? I need all the opinions I can get!
     
    Last edited: Aug 25, 2020
  16. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    I dont see what trust has to do with money.:mad:

    ETA: Arrogant doesnt begin to describe this ...person
     
  17. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

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    My honest opinion? If Mimi is eating, playing a bit, and the ketones are 0.9 on the blood ketone meter, I think you can hold off for a while on the vet visit.

    Maybe someone else will see something in her behavior right now that would warrant almost $500 (and let's be real; almost certainly by the time you are done it will somehow end up even more than that), but if it were me, I think I'd go with keeping an eye on her for a while.
     
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  18. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    I disagree You said Mimi hadn't been to the vet in a year.. Getting an annual exam, even an exam every 6 mos if your cat is over 10 yrs old is not unreasonable. I'd also point out that even with humans, a blood panel from 3 mos prior may not tell you anything about what's going on today. Getting a pancreatitis test might tell you something, or not. It won't tell you if pancreatitis is a result of some other problem or if triaditis is present. You can also tell the vet that flat out, you do not want the fructosamine test.
     
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  19. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

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    What am I missing? Is this not sufficient?
     
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  20. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    @Nan & Amber (GA)

    If there's an infection or inflammation, it could have started after the dental. Anything could have started after the dental. Rosa also indicated earlier in the thread that Mimi hadn't been to the vet in a year She's posted inconsistent information.
     
  21. Mimis mom

    Mimis mom Well-Known Member

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    I’m sorry she has been to the vet in May- she got her teeth cleaned, he examined her and also did a blood work up. I also should have specified she hasn’t been to this practice in a year (the one I took her to)
    I told him I didn’t want one and he acted like I insulted him and he said he doesn’t know how he’s going to properly treat her without one almost implying that if I don’t get one he’s turning her away- it was really bizarre. I told him I don’t need to know how her BG has been I have plenty of data from multiple tests a day. I explained TR to him briefly and I think he took it as “this know it all” and told me about his son who is 22 and diabetic :-/
    Also told me to stop testing for ketones it’s only going to make me crazy
     
  22. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    I'd take crazy over even the hint of keytones any day.:mad:
     
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