I need advice this is feeling like the end...

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Ben and Oreo

Ben and Oreo

Member Since 2022
Last night right before we were going to preshot test she wanted to be put on the ground and she preceded to vomit pink fluid with bloody flecks in it, following that she wasn't feeling well, the moment she walked away she fell over after a few steps and just sat there. So I skiped the shot at the time and took her to the er vet only to be downgraded from an emergency to a regular visit. Fast forward 4 hrs later, she got 3 xrays (swollen stomach, pretty large amount of feces which has yet to come out, and possibly inflamed intestines) a baseline bloodwork (nothing obvious), injections for electrolytes, cerenia, and famtidine, and was told its not that uncommon for them to vomit blood flecks (BullS%^T I've had 3 cats and have never seen one vomit blood before this). She got her insulin 4 hours late and literally filled half a litter box with urine in the span of 9 hrs which is insane even by diabetic standards. She's just been sitting in meatloaf position, isnt eating or drinking and has a bad skin tent so i'm sure shes dehydrated, vomited some non bloody fluid even through the cerenia, and feels really bloated. Do I give insulin now due to the high numbers or wait 2 hours till 9? Do I even bother with insulin or do I just plan on putting her to sleep...
 
Ben,
My thought after reading your post, is that Oreo might need subQ fluid - that is an action that may help quite a bit since dehydration can be dangerous. It might help her poop easier too. Also, I wouldn't skip insulin only because she is feeling poorly; high BG wouldn't help her feel better.
Of course I'm not familiar with all you have been through; Oreo is a beauty and I hope she can get better.
 
Not so much skipping she was 4 hours late last night and I need to know if it’s ok to give it now which would be at +9.5 of this cycle to try and get her back on schedule. As far as subQ (though she wasn’t dehydrated as of yesterday afternoon) I agree and as soon as vets start opening I’m gonna try my hardest to get her into one, but that’s hard every vet in this region of the state is 4 weeks out.... I overheard the er vet desk worker tell someone it would be a 46hr wait. I just wish they didn’t just take my money and blow me off last night.
 
I'm so sorry Ben, that sounds absolutely awful. One possibility for the subQ fluids is to ask the vet to sell you a kit, and give them yourself at home. It's pretty easy, and since they saw you last night, they shouldn't be too difficult about it. Crossing all fingers for you and Oreo.
 
The other concern I have for the insulin is that I’ll have to syringe feed and hope she holds it down. 20 minutes till her primary vet opens I’m gonna beg for them to see her honestly I don’t want to go back to the same place as last night they’ve done well for me in the past but I really felt ignored by this doctor. The fact that they held her from me for 4 hours even though I told them she needed insulin also pissed me off.
 
@tiffmaxee +10 331 one hour early would be in an hour. To worsen things it looks like they went center mass on her right ear and poked multiple times, its swollen pretty badly.
 
Omg. That’s abuse! I would shoot a reduced dose of 1.5 but see if your vet will see her. Have you called?
 
Just called the vet Its 8:19 am right now they will for sure see her at 2:30 pm but when her vet gets into the office they're gonna see if they can see her sooner. Yeah In 4 months of testing i've never seen her ear actually swell up, the occasional blood spot with a light shined behind it but even thats only happened about 3 times.
 
I knew when they said they were going to xray her they didnt intend on finding much, I even made the comment about not really being able to look at soft tissue with it, they had ultra sound equipment.
 
Ben and Oreo said:
I knew when they said they were going to xray her they didnt intend on finding much, I even made the comment about not really being able to look at soft tissue with it, they had ultra sound equipment.
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They definitely should have done an ultrasound. They seem so incompetent that I wonder if it would have given you much information. It needs to be done by a board certified radiologist or a very experienced internal medicine vet that does lots of them. My internist vet has a radiologist come in if he thinks there’s a major issue even though he’s more than qualified.
 
Idk I've suspected some kind of Gi tract issues for a long time but it's never been diagnosed and the pool of care up here is fairly small and really expensive even a basic vet visit I've found to run $500-$700 I'm not sure if the right vet exist up here. Honestly I love her so much but unless we can pinpoint something definitive today I'm not very optimistic, and I don't know if its right to keep dragging her along until she waste away... She's dealt with so much since April... More than I believe that I could withstand, it just kills me because up till the point she vomited right before shot time she was happy and healthy, was even excited for mealtime.
 
How long since she pooped?

Severe constipation can cause pain and vomiting; violent vomiting can indeed break tiny capillaries and cause flecks of blood to appear in the vomitus (very scary to see).

Ulcers can also cause blood in vomit, but with my cat, he was actually vomiting clots. That was treatable with a certain combination of medicines.

Any chance she ate something, like strong or a ribbon, that could be causing an abdominal blockage?

Chronic pancreatitis can also cause vomiting — Charlie used to vomit 10x a day and hunker down in the “meatloaf” position. The treatment is fluids, pain meds such as buprenorphine, an anti-naisea med such as ondansetron (or famotidine), and sometimes an anti-emetic (anti-vomiting) med such as cerenia. There’s a snap fPL test that can be run in-house or blood can be sent out. If there’s real concern about GI issues, blood can be sent to Texas A&M Univ for a GI panel (which can be enlightening).

Before giving up and putting her down, I’d ask about all of the above as well as whether they think the inflamed stomache/intestines are relevant to what’s going on with this acute episode, what it would take to get a diagnosis, and possible treatment options.

Dehydration alone can make them feel and look horrid. As can constipation and pancreatitis, etc. Sometimes when extremely dehydrated, it’s hard to get them back on track with only drinking or subQ fluids and a day on IV can make a world of difference.

I don’t know the history so those are just a few off-the-cuff thoughts. I hope you get some answers today and a hopeful prognosis.
 
Not likely that she ate anything to cause a blockage and I'd imagine that would show up on Xray, though I'm still waiting on a large poop that was on the xray normally she doesn't vomit outside the occasional furball last night and this morning are the only times this month. Early on in diagnosis she had consistently dark poop and green poop was never really sure if it was black, it was always formed then in late June it turned to diarrhea, which seemed to clear up with fortiflora, but since then its been on the lighter end of brown formed but often times with nodules on the sides and the tail ends are often dark. I know that dehydration makes them feel bad, but I'm concerned why she went from well hydrated to bone dry in less than 12 hours. Her kidney and liver values were good.
 
Is she running a fever? Normal is approx 99.5 up to 102.5 for a cat.

edited to add: Did the “bloating” happen overnight?. Hold the palm of one hand on one side of her belly then gently tap on the other side; do you feel the percussion?
 
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Not sure on the fever I don't have a thermometer the vet pushed her appointment forward to 11 which is in an hour and 10 minutes. She's pretty much secluded herself gonna get a +2 In a few minutes and start gathering things.
 
Vetty vines. Let us know what your vet says. She could just be very constipated and need an ennima. Let us know how it goes. The fact that all was good before she vomited means there might be an easy fix.
 
At the vet gonna try to work through this as pancreatitis subQ fluids, bupe, and syringe feeding to see if there’s improvement. I need to ask but we’re probably gonna keep using the antacid.
 
@tiffmaxee I need to work her back to a 6 and 6 schedule I shot the 1.5 at around 8:30 she's also pretty hyperglycemic right now 383 at +5, I'm feeding by syringe so I don't know that her usual 3.5 units is safe because in the event that she nose dives I don't think I'll be able to recover it but at the same time 1.5u didn't seem to really do the trick back when she was working her way up the ladder. I'm also gonna have to figure out a new place to shoot for the time being because they used the scruff for the subQ.
 
For pancreatitis you don’t give antacids normally. You need cerenia or ondansetron for nausea. The reduced dose was a one time thing because he wasn’t eating and tge vomiting. I’d go back to 3.5 tonight. You can shoot 1/2 hour early every 24 hours or 15 minutes each cycle. Since you gave a token dose this morning you could probably give insulin an hour early if high and you are confident he will eat but best to not give it more than 30 minutes early. See how she’s doing at pmps and how high her bg is. She’s also bouncing from the greens a few nights ago.
 
At this point we're gonna try and pull her out of this, and I'm dedicated to help her as long as she has a good chance. But honestly I can't find myself getting my hopes high because they've been crushed so many times before. But I really hope this is just a small speed bump.
 
We've been down this road before the last time was in early may and I have 10 days worth +2 more boxes of refill, is it ok to hold off on testing till shot time, I think its only gonna stress her out more and I don't think she's gonna hypo. I was really hoping she wouldn't have another bout. At the moment the vet is treating this as "pancreatitis" and if we can pull her through this I think I'm gonna have some test done.
 
[QUOTE="Ben and Oreo, post: 2989844, member: 36272" At the moment the vet is treating this as "pancreatitis" and if we can pull her through this I think I'm gonna have some test done.[/QUOTE]

How was pancreatitis diagnosed the first time? Max had chronic pancreatitis for a few years before becoming diabetic. He was diagnosed with the SPECfPL blood test.
 
When she was diagnosed it was predominantly symptomatic with extremely elevated Lipase. I know that's somewhat nonspecific but each time we dealt with it we used the process of pain and nausea management while trying to get as much food in her as possible to allow for insulin the first time in late April sent her to the er with early caught DKA so she only took 24 hrs to stabilize. The second time in early may I caught it early and started home treating with cerenia and bupe and she didn't need to be hospitalized. I'm not positive if they can do the inhouse Specfpl test or not, the problem with sending test out is usually a cost and time deal, by the time you get the results its already either passed or it's too late to act. I did talk to him about a GI panel, the final cost to send that out would be just over $400 and he mentioned that's best to pair with ultrasound imaging to help verify potential findings.
 
We stopped testing and treated symptoms too. Don’t waste money on the in house SNAP test as if in the gray zone will register as she doesn’t have it. Cats can feel just as sick with a low positive as a high positive.
 
That's pretty much my vets position he said that the odds make it more likely that its pancreatitis but the fact is whether it is or isn't doesn't change the treatment that much she's in pain and nauseous regardless. Just gave 8 mg of cerenia dissolved into 2.5 ml of food+water not sure how much she swallowed but she's pretty much impossible to pill when she's felling like this. Probably gonna do insulin at 7:30 so about a little over an hour from now and bupe at 8.
 
Same situation with my chronic pancreatitis and asthma cat Wicket - we suspect he has both pancreatitis and IBD, but no point in doing endless tests. He is currently well controlled with 2.5mg pred/day and 25mg gabapentin AM+PM. I figured out that constipation seemed to be the main trigger for his flare ups, and adding pumpkin and other supplements to keep him regular has really helped keep flares at bay.

Hope you can find out what triggers Oreo, and keep her pain-free longer with fewer flare ups!
 
Could be constipation, still waiting on this poop he didn't want to immediately do an ennima without giving it a chance to pass on its own.
 
Try “Smooth BM Gold” drops, you can get them on amazon. I give them to Wicket twice a day and they are magic. I also give him 2 tablespoons of pumpkin every day, and a few times a week 1/4 tsp miralax in canned food with added water. One thing alone never worked for us, but this combination has kept him going. The drops are seriously awesome especially when you know they HAVE to go but somehow don’t. Really precipitates the whole situation and don’t seem to cause any discomfort.
 
Ben and Oreo said:
Could be constipation, still waiting on this poop he didn't want to immediately do an ennima without giving it a chance to pass on its own.
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Have you ever tried Miralax? It's a tasteless powder that can be mixed into food or syringed with water (to make sure it gets into him). It's used a lot in our diabetic cats and is available at Walmart or any human pharmacy.

Usual starting dose is 1/8tsp twice a day (and the more water you can get into him, the better. It also helps the Miralax work better)
 
I also suggest Miralax or
The generic version of Miralax is polyethylene glycol 3350, which is cheaper than the brand name.
CVS , Walmart, Walgreen's, even supermarkets have their brands
When I had to use it for Tyler's brother he never tasted it in the wet food, just mix in water with it and mix it up good
 
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Ben and Oreo said:
Could be constipation....he didn't want to immediately do an enema without giving it a chance to pass on its own.
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Without the blood flecks this sounds just like our Sam and Daniel. Sam is obese and was put on 'magic beans' weight loss food, Daniel has suspected megacolon. In both cases they were so impacted with an enormous amount of poop they both came within 48 hours of bursting internally and dying from the resultant sepsis.
I say 'magic beans' weight loss because it's never worked, they just eat more and in Sam's case it put him at death's door within a week.
Regarding the enema. It was never going to pass on it's own and in the lower colon it can tear the lining and then you're both in big trouble. Both Sam and Daniel needed three enemas and a lot of palpation. We were warned we might have to drive Daniel to the nearest vet college for emergency surgery but got lucky this time.
Daniel will be on PEG the rest of his life and I'll never again use weight loss food.
I cannot comment on the advice others have given you, I just don't you to end up where we ended up with a combined $7,000 bill. As far as I know an enema is just uncomfortable and not dangerous if done right, what was your vet thinking of?
 
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