HELP!!Sudden poor appetite

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I know its not easy... I never had to worry about ketones thank God. The learning curve is steep but I believe you are up for the task.

BTW Candi is as cute as she can be. What a cutie pie!:bighug:
 
Ketones can develop in a diabetic when there's not enough food + not enough insulin + a stressor (infection/inflammation). The high numbers aren't a direct cause, they just tend to be associated with the not enough insulin + stressor parts of the equation.

Similarly, lower BG numbers are not in any way a protectant against ketone development! That's why we get concerned when low numbers and low appetite lead to shots being skipped. And when there's an infection on board as well, all the alarms are flashing red.

Becca84 said:
It's just confusing. I thot it was a good thing but it might indicate ketones is scary. Do you think I need to set up a vet appointment for monday?
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When you get that ketone test, anything above "trace" warrants a trip to the ER vet-- waiting until Monday is not an option. If ketones are negative and her appetite continues poor, you will want to at least call your vet for advice and possibly take her in. She may just need a different antibiotic, or possibly an anti-nausea med to counteract the side effects (I think Clavamox is one of those that is notorious for causing nausea).
 
Hi again, Becca.

I'm sorry you're dealing with such a distressing and tricky situation. :bighug:

Becca84 said:
How long should I wait to test after shes eaten to see if I should shoot you think?
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Please note, the following suggestions are based on an understanding that Candi does not have a history of throwing ketones or episodes of DKA.

First up, an important general safety note:

Based on the PM reading of 97 (Alphatrak) I think the 1.5IU Vetsulin dose is a bit too high, even for a normal day, and therefore suggest that you reduce it going forward. Candi has hit BG below 90 on an Alphatrak on this dose. The FDMB Vetsulin guidelines indicate a dose reduction if BG falls below 90 on a human meter, so the threshold for dose reduction on an Alphatrak meter would be a higher value (low 100s as a rough estimate).

For today, if Candi does get high enough to give insulin (>200, possibly even >220 on an Alphatrak), I very much recommend you give a dose smaller than 1.5IU for the reasons given above.

* Wait two hours after food.

* Test.

* If BG high enough to give insulin, feed Candi again. (Over 200 minimum.)

* If BG almost high enough, stall without feeding, test again in 20 minutes and, if now high enough to give insulin, feed and go to next step.

* If, and only if, she eats enough - a very good meal, just in case she won't eat more later while the insulin's active in her system - wait 30 minutes and then administer the reduced dose of insulin.

Monitor BG throughout the cycle - especially in period from +1 to +4 when BG drop is likely to be fastest and strongest - until numbers rise significantly (usually after +7 or +8). If numbers fall significantly any time after dose onset then intervene with food (and honey if necessary) to keep numbers in the safe range. Post for help but bear in mind that the board is quieter at weekends. (I won't e around most of today either, I'm sorry to say. :( )

If Candi's appetite remains very iffy, you could consider giving a token dose. I would not be comfortable suggesting any more than 0.25IU and only on the proviso that you can monitor her closely throughout the cycle to keep her safe.

If in any doubt, especially if you can't monitor Candi throughout the cycle, it would probably be safer to skip, this time with the proviso that there is active monitoring for ketones today.

To catch a urine sample, spread some plastic food wrap over the surface of the litter in the box. Push down in the litter in her 'favourite spot' if she has one. It will allow the urine to pool a bit and make it easier for you to get a sample. Other tips for collecting urine samples here.

* If clear for ketones, test again tomorrow. (By then you'll hopefully have been able to get to talk with - and hopefully visit - your vet.)

* If trace ketones, test again later today and in the morning (assuming that subsequent tests are negative or trace).

* If any higher than trace, take Candi to a vet immediately for emergency treatment to flush out the ketones.

As others have posted above, if Candi's having problems smelling her food then she'll be disinclined to eat. If you haven't already done so, try warming her food a little to increase the aroma. Also try to see whether she might take a bite or two from your hand. Sometimes that can help reassure a kitty that the food's safe to eat even if sense of smell's a bit off.

It'd also be a good idea to check Candi's behaviour round food points to any nausea. Clavamox can really upset the GI tract and give rise to eating difficulties. (If Candi's stools have loosened since starting the course that would be a pointer to a GI disturbance.) Here's a helpful resource:

Nausea Symptoms Checklist and Treatments

A simple thing to try is raising up food and water bowls a couple of inches to make it more comfortable to eat if the tummy's a bit iffy. More suggestions here (including suggestions on cat-friendly baby foods (no onion, no garlic!) that can often tempt a cat to eat when it won't touch regular foods):

Persuading Your Cat to Eat

Hope some of the above helps. (Sorry it took me so long to type this.)


Mogs
.
 
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Nan & Amber (GA) said:
I think Clavamox is one of those that is notorious for causing nausea.
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And how! My civvie, Lúnasa, had to have two month long courses back to back to treat UTIs (she has CKD, hence the longer courses). It was the devil's own job trying to get food into her. She'd have starved were it not for twice-daily ondansetron for the nausea. She also had diarrhoea for so long on the second course that I began to despair of her ever having a normal poop again! She was miserable while taking it too, poor creatúir. :( (((The Noodle)))


Mogs
.
 
Critter Mom said:
Hi again, Becca.

I'm sorry you're dealing with such a distressing and tricky situation. :bighug:


Please note, the following suggestions are based on an understanding that Candi does not have a history of throwing ketones or episodes of DKA.

First up, an important general safety note:

Based on the PM reading of 97 (Alphatrak) I think the 1.5IU Vetsulin dose is a bit too high, even for a normal day, and therefore suggest that you reduce it going forward. Candi has hit BG below 90 on an Alphatrak on this dose. The FDMB Vetsulin guidelines indicate a dose reduction if BG falls below 90 on a human meter, so the threshold for dose reduction on an Alphatrak meter would be a higher value (low 100s as a rough estimate).

For today, if Candi does get high enough to give insulin (>200, possibly even >220 on an Alphatrak), I very much recommend you give a dose smaller than 1.5IU for the reasons given above.

* Wait two hours after food.

* Test.

* If BG high enough to give insulin, feed Candi again. (Over 200 minimum.)

* If BG almost high enough, stall without feeding, test again in 20 minutes and, if now high enough to give insulin, feed and go to next step.

* If, and only if, she eats enough - a very good meal, just in case she won't eat more later while the insulin's active in her system - wait 30 minutes and then administer the reduced dose of insulin.

Monitor BG throughout the cycle - especially in period from +1 to +4 when BG drop is likely to be fastest and strongest - until numbers rise significantly (usually after +7 or +8). If numbers fall significantly any time after dose onset then intervene with food (and honey if necessary) to keep numbers in the safe range. Post for help but bear in mind that the board is quieter at weekends. (I won't e around most of today either, I'm sorry to say. :( )

If Candi's appetite remains very iffy, you could consider giving a token dose. I would not be comfortable suggesting any more than 0.25IU and only on the proviso that you can monitor her closely throughout the cycle to keep her safe.

If in any doubt, especially if you can't monitor Candi throughout the cycle, it would probably be safer to skip, this time with the proviso that there is active monitoring for ketones today.

To catch a urine sample, spread some plastic food wrap over the surface of the litter in the box. Push down in the litter in her 'favourite spot' if she has one. It will allow the urine to pool a bit and make it easier for you to get a sample. Other tips for collecting urine samples here.

* If clear for ketones, test again tomorrow. (By then you'll hopefully have been able to get to talk with - and hopefully visit - your vet.)

* If trace ketones, test again later today and in the morning (assuming that subsequent tests are negative or trace).

* If any higher than trace, take Candi to a vet immediately for emergency treatment to flush out the ketones.

As others have posted above, if Candi's having problems smelling her food then she'll be disinclined to eat. If you haven't already done so, try warming her food a little to increase the aroma. Also try to see whether she might take a bite or two from your hand. Sometimes that can help reassure a kitty that the food's safe to eat even if sense of smell's a bit off.

It'd also be a good idea to check Candi's behaviour round food points to any nausea. Clavamox can really upset the GI tract and give rise to eating difficulties. (If Candi's stools have loosened since starting the course that would be a pointer to a GI disturbance.) Here's a helpful resource:

Nausea Symptoms Checklist and Treatments

A simple thing to try is raising up food and water bowls a couple of inches to make it more comfortable to eat if the tummy's a bit iffy. More suggestions here (including suggestions on cat-friendly baby foods (no onion, no garlic!) that can often tempt a cat to eat when it won't touch regular foods):

Persuading Your Cat to Eat

Hope some of the above helps. (Sorry it took me so long to type this.)


Mogs
.
Click to expand...
Thank you so much!
 
Critter Mom said:
And how! My civvie, Lúnasa, had to have two month long courses back to back to treat UTIs (she has CKD, hence the longer courses). It was the devil's own job trying to get food into her. She'd have starved were it not for twice-daily ondansetron for the nausea. She also had diarrhoea for so long on the second course that I began to despair of her ever having a normal poop again! She was miserable while taking it too, poor creatúir. :( (((The Noodle)))


Mogs
.
Click to expand...
That sounds just pitiful!
Yeah I'm sure she has diarrhea and I'm certain she feels maybe at the least nauseous. Its never like her to act like this. I'll watch it and definitely get her in tomorrow to the vet! Thanks!
 
Nan & Amber (GA) said:
Awwww..... poor little Noodle! I felt bad even 'liking' that report on her woes, that sounds absolutely miserable!
Click to expand...
It was a relief to stop them, Nan. Her GI tract got so messed up on the second course that I asked the vet to check her for pancreatitis (she had an acute episode a few years ago after GI problems caused by her hyperT). Thankfully she was negative but the vet agreed to prescribe bupe for her. It helped her to eat better, thank God, and her poops seem to be normalising since cessation of the co-amoxyclav (anti-jinx!). The Noodle has regenerative anaemia thanks to the CKD so any inflammatory processes are a really big deal now. (((Noodle)))

ETA:

BTW, the first course was for a staph infection but when the post-course follow-up urinalysis C&S was done, the staph infection was gone, only to be superseded by an E. coli infection. Got a call from the vets on Saturday to say that the follow-up C&S after the second course was clear! Also her haematocrit is still OK. I am so relieved.


Mogs
.
 
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jt and trouble (GA) said:
as far as I understand high numbers and no insulin are a recipe for keto
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nes BUT the fact that she could have an active infection THAT also can help ketones to develop.
PLEASE Nan correct me if I'm wrong.
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Hey just checked her ketones with a ketone test strip at +40 since last shot and it looks negative.
 

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Nan & Amber (GA) said:
Ketones can develop in a diabetic when there's not enough food + not enough insulin + a stressor (infection/inflammation). The high numbers aren't a direct cause, they just tend to be associated with the not enough insulin + stressor parts of the equation.

Similarly, lower BG numbers are not in any way a protectant against ketone development! That's why we get concerned when low numbers and low appetite lead to shots being skipped. And when there's an infection on board as well, all the alarms are flashing red.



When you get that ketone test, anything above "trace" warrants a trip to the ER vet-- waiting until Monday is not an option. If ketones are negative and her appetite continues poor, you will want to at least call your vet for advice and possibly take her in. She may just need a different antibiotic, or possibly an anti-nausea med to counteract the side effects (I think Clavamox is one of those that is notorious for causing nausea).
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20201115_114842.jpg
 

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Congrats on the ketones test! Yes, that looks negative, as long as that picture was taken at the specified time (the strips will darken over time, so you have to look at them at the number of seconds they say in order to get an accurate reading).

:)
 
Nan & Amber (GA) said:
Congrats on the ketones test! Yes, that looks negative, as long as that picture was taken at the specified time (the strips will darken over time, so you have to look at them at the number of seconds they say in order to get an accurate reading).

:)
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And now she vomited. I'm really guessing the antibiotics are to blame. Shes never never been good with antibiotics in the 11 years I've had her. Diarrhea and vomiting has always been side effects except for the injectable antibiotic which I dont understand why they didnt give her. She already had one injection of antibiotics so I guess that's why?
 
It looks negative to me.

I cannot access your spreadsheet.
Can you go up to the top right hand corner and click "share"?

While you are there, you can change the link to your spreadsheet.

To change the link on your spreadsheet.
1. Copy the link. It starts off like this: docs.google.com/spreadsheets/blahblahblah This is your URL.
2. Go up to the top right hand corner and click on "Becca84"
3. Click "Signature"
4. Delete "CandiSS"
5. Type "CandiSS"
6. Make sure to highlight all of "CandiSS"
7. In the upper left hand corner of the typing box you will see a link symbol. It looks like this:
upload_2019-9-19_11-15-25.png
Click on the link.
8. A new box should open up which tells you to paste the URL
9. Paste the URL
10. Save changes.

I'm not a techie but I think this should work.
 

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Red & Rover (GA) said:
It looks negative to me.

I cannot access your spreadsheet.
Can you go up to the top right hand corner and click "share"?

While you are there, you can change the link to your spreadsheet.

To change the link on your spreadsheet.
1. Copy the link. It starts off like this: docs.google.com/spreadsheets/blahblahblah This is your URL.
2. Go up to the top right hand corner and click on "Becca84"
3. Click "Signature"
4. Delete "CandiSS"
5. Type "CandiSS"
6. Make sure to highlight all of "CandiSS"
7. In the upper left hand corner of the typing box you will see a link symbol. It looks like this:
Click on the link.
8. A new box should open up which tells you to paste the URL
9. Paste the URL
10. Save changes.

I'm not a techie but I think this should work.
Click to expand...
The uppercase "C" in CandiSS should let u in...I tried to shorten it but it never worked
 
Becca84 said:
The uppercase "C" in CandiSS should let u in...I tried to shorten it but it never worked
Click to expand...
When I click on the "C" I'm told I need to request access.

The difficulty with just the "C" highlighted is that it is not easy to notice because the type used in the signature is so small.
 
Red & Rover (GA) said:
Will Candi eat out of your raised hand?
And what @Critter Mom mentioned earlier. Raising the bowls a couple of inches is a simple trick.
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Well she just vomited and is looking at the food as if she wants to eat but scared. I think I'm stopping the antibiotics to see if that will help and I have raised her bowl and shes still unsure. I'll run and get pepcid in a few minutes.
 
Becca84 said:
And now she vomited. I'm really guessing the antibiotics are to blame. Shes never never been good with antibiotics in the 11 years I've had her. Diarrhea and vomiting has always been side effects except for the injectable antibiotic which I dont understand why they didnt give her. She already had one injection of antibiotics so I guess that's why?
Click to expand...
My cat gets the runs too. Probiotics could help. FortiFlora
 
Becca84 said:
Well she just vomited and is looking at the food as if she wants to eat but scared.
Click to expand...
That sounds very much like nausea-related behaviour (obviously hungry and interested in food but reluctant to eat).

Becca84 said:
I think I'm stopping the antibiotics to see if that will help
Click to expand...
Skipping a dose shouldn't be a big issue (I did on occasion with the Noodle, just to give her a break).

I don't know whether this might be an option in the time of covid but it's also possible to give co-amoxyclav by injection. Each injected dose lasts 3 days and it's not as hard on the GI tract. Maybe ask your vet about this tomorrow?

Word of warning: If your vet proposes giving Candi a long-lasting antibiotic injection, check whether it's Convenia (generic name is cefovecin). Convenia is often prescribed wrongly for all manner of infections, purely on the basis that it removes the need to pill the cat. However, it is only truly effective for skin infections. I'd suggest asking about an antibiotic better suited to Candi's current needs. (Note: There have been reports of possible adverse reactions to Convenia - see catinfo.org on this subject.)


Mogs
.
 
Critter Mom said:
That sounds very much like nausea-related behaviour (obviously hungry and interested in food but reluctant to eat).


Skipping a dose shouldn't be a big issue (I did on occasion with the Noodle, just to give her a break).

I don't know whether this might be an option in the time of covid but it's also possible to give co-amoxyclav by injection. Each injected dose lasts 3 days and it's not as hard on the GI tract. Maybe ask your vet about this tomorrow?

Word of warning: If your vet proposes giving Candi a long-lasting antibiotic injection, check whether it's Convenia (generic name is cefovecin). Convenia is often prescribed wrongly for all manner of infections, purely on the basis that it removes the need to pill the cat. However, it is only truly effective for skin infections. I'd suggest asking about an antibiotic better suited to Candi's current needs. (Note: There have been reports of possible adverse reactions to Convenia - see catinfo.org on this subject.)


Mogs
.
Click to expand...
I agree. I think we might just stop them all together.
 
Becca84 said:
I FIXED IT! link sharing wasn't on
Click to expand...
To make your spreadsheet link more visible:

1. Copy the link to your spreadsheet to the clipboard.

2. Edit your FDMB signature.

3. Highlight the 'C' with the current link and then click on the Break Link icon:


upload_2020-11-15_18-14-32.png



3. Now highlight 'CandiSS' in your signature.

4. Click on the Link Icon and paste in the link from the clipboard.

You should then see 'CandiSS' appear in blue text (showing it's a web link). Save the changes and everyone should find it easier to see the spreadsheet link in future. :)


Mogs
.
 

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JanetNJ said:
Whooohoo. Well done! :) you really are a rock star. Your cat is so lucky to have you. :)
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This is my weekend to sleep, I usually wake up at 730am to feed her and go back to bed, but I've been so worried over this girl I've stayed up and now it's like 1:30p. Lol she means the world to me and I dont care if I lose sleep for her. I'm about to go buy some pepcid for her. Shes my special girl!:joyful:
 
We use fortiflora If I dont sprinkle it on Zoes food she gets the runs. Have NO idea why or how that works but it does.
Its not the best probiotic. But the added benefit is that it entices them to eat.
 
Critter Mom said:
That sounds very much like nausea-related behaviour (obviously hungry and interested in food but reluctant to eat).


Skipping a dose shouldn't be a big issue (I did on occasion with the Noodle, just to give her a break).

I don't know whether this might be an option in the time of covid but it's also possible to give co-amoxyclav by injection. Each injected dose lasts 3 days and it's not as hard on the GI tract. Maybe ask your vet about this tomorrow?

Word of warning: If your vet proposes giving Candi a long-lasting antibiotic injection, check whether it's Convenia (generic name is cefovecin). Convenia is often prescribed wrongly for all manner of infections, purely on the basis that it removes the need to pill the cat. However, it is only truly effective for skin infections. I'd suggest asking about an antibiotic better suited to Candi's current needs. (Note: There have been reports of possible adverse reactions to Convenia - see catinfo.org on this subject.)


Mogs
.
Click to expand...
I've skipped 3 doses. I've checked her bg @ +42.5 and shes 203.
 
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