I think Timmy is Hypo

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Terwilliger1

Terwilliger1

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My Timmy hasn't been eating as much since her tooth extractions on Friday. She at a little this morning and I gave her insulin. Tonight she won't eat anything and vomited when she smelled her Pill Pocket (they do kind of smell like farts). I tested her at +13 and she was 48. The lowest she's ever been. I rubbed some corn syrup on her gums and testes her +14 and she was 40. I squirted 1ml of corn syrup in her mouth, and 10 minutes late she vomited. I tester her 20 minutes ago and she was 43. I called the vet and she said they were closing soon, so just try to get her to eat something and take her to the emergency clinic if she wasn't doing better. Timmy is alert and washing herself and walking around. She just drank some water. She's rubbing on furniture and purrs when I pet her. I'll test her again pretty soon. I've tried to give her 4 kinds of food, even dry soaked in a little water, and even bread. I'm afraid if I squirt some watered down food in her mouth she will vomit again and get even more dehydrated. Should I try more corn syrup, or just keep testing.
 
No, she has had no insulin. Just tested and she is 49. Looks like we are on the way up. Sorry if I freaked anyone out. If the corn syrup wears off, could she start to go down again? Should I give her more later if she doesn't eat, seeing as she threw up most of the last bit I gave her.
 
How many extractions did Timmy have and have you been giving antibiotics and pain meds, and if so, what have you been giving. Did your vet do post-extraction x-rays?

What time did you give your last shot (i.e, how close to your PMPS are you)?

Friday is a long time for a cat not to be eating well.
 
Argh, I just typed a response and it didn't post. She had 10 extractions. Pain med was Gabapenting twice a day. She had two doses on Sat, and one on Sunday morning. She vomited the evening dose on Sun. No pain med since. AB was Clavamox liquid. She had two doses on Sat, and one on Sun. Vomited the evening dose on Sunday. Switched to Zenequin pills after a call to the vet Monday. She had one dose Monday night. She usually eats 8-9 ounces of FF a day and has been eating 3-4 oz since surgery but in small snacks. She would not eat anything tonight. Her last insulin was 5am (1U), and it is now 8:30 my time. She has vomited twice tonight, but has been drinking some water.
 
I saw your response to Dr. Lisa regarding no post-dental x-rays.

We know this isn't a reaction to Convenia, which is what I was concerned about. That's good.

Gabapentin is for neurologic pain. It's not an appropriate met for dental pain. Something like buprenorphine is more appropriate.

By this time, I would have expected Timmy to be feeling better and eating reasonably well. I am concerned that there's an infection. Without x-rays, there's no way to know if there was a bit of root that was left and this may be causing a problem.

Without benefit of any spot checks, there's no way to know how long Timmy was in low numbers. Were there any other symptoms besides vomiting? (I'm guessing not or you would have mentioned it.) By this point, unless Timmy's numbers really tanked early in the day, I would have expected the effects of Lantus to have worn off. A true Lantus hypo can last a long time -- we often end up monitoring very closely for 16 hrs. I'd really encourage you to get some spot checks each cycle so you know your cat is safe.

A cat that's not eating well since Friday, is now vomiting repeatedly after eating, and is sitting in low numbers -- to me this is a visit to the ER. With a cat that's not getting sufficient calories after 3 days can be a cause for liver problems.I know the ER is expensive, but I'm concerned.
 
Her pre-dental blood work didn't show any liver problems. Are you saying she might have developed problems due to an infection or some of the meds? She was on Clavamox for 8 days prior to the dental and tolerated it well. I assumed whe wasn't eating as much because of the mouth discomfort. The vomiting has been the only symptom I've been concerned about besides eating less. Other than that she is acting fairly normal. I will take her to the ER if I need to, but have a vet appointment in the morning. What kind of liver issues would send her downhill this quickly? I was concerned about her being hypo, but now I'm confused.
 
Timmy just ate a little food. Her BG was before eating was 46. Not much change. I'm not prepared to head to the ER just yet, but will watch her closely.
 
Hoping there are lots of eyes on you tonight. Are you also on the page for your insulin - not just the main board?
 
Hepatic lipidosis ("fatty liver") can develop fairly quickly when a cat is getting insufficient calories. The general rule of thumb is that a cat needs to be eating within 3 days. I'm sure Timmy was fine before the dental. I'm more concerned with the aftermath. When Gabby had 5 extractions, she was eating well after 24 - 36 hours. (My vet gave her a shot of clindamyacin post-procedure and buprenorphine for pain.)

If there was a root that was left in or if there's an infection around a suture, this can also be a cause for infection. Usually, we encourage people to make sure their vet will get pre- and post-dental x-rays so you know if there are any underlying problems before the dental and to make sure there are no issues after the procedure.

Vomiting can be due to any number of things. There's no way to know if Timmy happened to drop into low numbers early in the cycle or late or whether he was having symptomatic hypoglycemia or just skirting around in lower numbers. Certainly, not being able to eat without vomiting is not helping to get and keep numbers up. (Do you have a recent test?)

Have you been getting ketone tests? If you can stalk Timmy to the litter box and get a ketone test, that would be reassuring. Infection, not enough insulin, and not eating can all contribute to diabetic ketoacidosis. While this is not typical when numbers are low, it can happen.
 
Hey, I just popped in and saw your post. I'm glad Timmy ate a little. Do you have any high carb food with gravy that you can offer her? That might help her numbers rise a bit.

I think what Sienne was referring to was hepatic lipidosis, or fatty liver disease. This is a condition that can develop quite quickly in a cat that's not eating. I'm sure Sienne or someone else has more info, but it is a very serious condition, caused by too little food in the system, so the liver has to start converting fat cells to usable energy, and if that continues, the fat cells build up in the liver If Timmy was eating fine before her dental procedure, it would not have been an issue at all in her bloodwork, but rather would develop since the procedure in the days she has not eaten enough. The treatment is to get calories into the cat. It can be fatal if not treated.

I hope that Timmy will start eating tonight and stop worrying her momma!
 
Timmy just ate some chicken. A pretty good amount too. I hope she will hold it down and eat a little more. Thanks for everyone's advice. I'm going to sign off. I was so worried something would go wrong with this dental procedure and was reluctant to do it. I hope everything works out okay tonight.
 
Timmy is much better this morning. I finally got her to eat enough last night that her BG went up to 82. This morning she had breakfast and is now at 146. I'm hoping the vet can shed some light on if this was just hypo or something more serious. Thanks for the support last night.
 
Some meds can cause stomach upsets with vomiting - perhaps the Gabapentin is doing it.
 
Gabapentin makes me very sick. It makes me nauseaus, dizzy and makes me retain water. I wouldn't be surprised if that was making him sick.

Melanie & Racci
 
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