Junior not eating, meds, dose question

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kay&junior

Member Since 2011
http://felinediabetes.com/FDMB/viewtopic.php?f=32&t=71497

I have been communicating with Sienne, and she asked me to post here for more help and eyes...

Junior is having problems, and I am a nervous wreck. he won't eat, except from my fingers since yesterday, he ate some breakfast, little lunch, by himself, and 1/2 his supper by my fingers. I did give him his shot last night, but not this morning, as he didn't come close enough to eating enough for a shot.

his fur is still soft & silky, his eyes are clear, he has some bad breath, but his teeth look ok, IMHO. he can run around, but when he sees the needle, he runs.

I am thinking I should go down on his dose, any ideas?

Thanks for all your help Sienne.
 
I'm actually thinking that you may want to increase Junior's dose. You're seeing some blue nadirs but there's still plenty of room to increase.

To reiterate what I said via PM, there's a risk here of ketones. Any sort of infection or inflammation coupled with poor appetite and decreased insulin is a recipe for ketones. What we've typically suggested to anyone with a cat that has been battling ketones is that what you feed doesn't matter. Getting food in your cat is the overarching goal. So, if Junior will eat HC, give him HC so you can shoot. If you need to raise the dose to offset the effects of food, that's fine. (When Desi was dealing with one of her cats having repeated bouts of DKA I told her that I didn't care if she had to Tawny an ice cream sundae -- if that's what she would eat, it would be fine.)

I would do whatever you can to check for ketones. They can develop in a surprisingly short period of time and numbers do not have to be high for them to occur.

Also, if Junior has bad breath, the first possibility is that his teeth are funky. It's very hard to determine if there's a dental problem if the vet (or you) are checking when a cat is conscious. Usually, it's only when a cat is sedated that you can get a good look. The second possibility is that something's off with his stomach.

I'd also suggest getting in touch with Karrie/Maverick. She is a wealth of knowledge when it comes to assist feeding.
 
Kay

Sienne asked if I would also chime in here and I agree with her that it looks like he needs more insulin. I think it is really important for you to get those mid cycle tests as often as you possibly can so that he's not sitting at numbers higher than he should be. I, for one, am reticent to suggest dosecreases if I don't know how low they've been getting. I'm glad you have the most recent mid-cycle tests....as Sienne said, that tells us he's got some room for a dosecrease.
I agree .25u dosecrease is in order sooner rather than later especially if there is any possibility of infection at all. Does he seem dehydrated to you? Are his gums slick? When you pick up the fur on his scruff and release it, does it pop right back into place or is it slow to move back? If he seems dehydrated, you should talk to your vet about getting him some subq fluids.

In order to get him eating, have you tried putting freeze dried chicken dust, bonito flakes, parmesan, fortiflora....any of those on his food? Have you tried other cat foods/flavors? How about chicken or turkey baby food (I believe the Beech Nut is the one with nothing but chicken in it....avoid the ones with any other ingredient).

If you need to assist feed him, do it. If you have a blender, puree the food with some water and put it in as large a syringe as you have....I like the 10-12 ml syringes. I puree the food and then pour it into the syringe. You don't want it runny...just a nice consistency almost like pudding. Here is one of the best assist feeding videos I've seen:

[youtube]U6o17wH6ujk[/youtube]

Please let us know how we can help.
 
Our Zener has appy issues, and periods of inappetance, though no medical issues other than his FD. We used this video to learn to assist feed and had to assist feed him for about 5 days in January when he stopped eating all together after an episode of vomiting and severely decreased stomach motility. Since then he has had short bouts of not eating but we try to manage with meds, some days are better than others. Cerenia is what we have used for vomiting, but it also seems to have a GI anti-inflammatory and pain reduction effect. We also give him ondansetron on a regular basis, an anti-nausea drug. And when needed, we use cyprohexadine, an appetite stimulant, in combination with the ondansetron for anti nausea. If you give a kitty an appy stimulant and the kitty is also nauseated, vomiting can result. The ondanstron and cypro are inexpensive, the cerenia injections are expensive. It was the only thing that helped him start eating on his own again back in January. We have our paws crossed that Junior starts eating soon, and we completely understand how difficulty this is.
 
Re: Junior not eating, meds, dose question UPDATE

Good morning,
Last night was ok, google docs not letting me update...so here goes...
he ate lunch from his feeder, don't know if his brother helped.
PMPS - 314, and that was with no shot in AM, gave 2 units after eating.
he ate a 1/2 can by himself with lots of water, then I helped him finish the rest.
in the middle of supper, which took about 45 minutes, he went to pee, so I got 2 urine tests in, 1 from the dipstick under his butt, and the other from the wonderful Breeze litter system Box. results not good to me, e-mailing vet next, she doesn't open til 9.00am.
Ketones-Negative!
Specific Gravity- 1.025 to 1.030
Protein-Trace
PH- 6.0
Leukocytes- small to mod, ( + to ++ )
color was clear & yellow, not cloudy at all. no straining, he lloked funny at me when I stuck the dip stick under his butt, but it worked!
Bedtime 4+ was 260 and he had a 1/2 can salmon by himself.
I did not start the Mirtazapine last night as the directions were not fully understandable, so will need to clarify that, and will be looking on the web today for FortiFlora as suggested. Clindamycin he starts tonight.
This AMPS was 278, He ate 1/2 can by himself, waited a few minutes, had help with the second 1/2, and got a shot, 2 u Lantus.
I left his feeder set for noon, and have the next 4 days off, so he will be getting intensive care.

anything else I need to do, I got the suggestion on the baby food, will get that on the way home, living in a tourist valley, I shop before they get here.

should I increase tonight to 2.25u?

any and all help appreciated, will get lots of numbers over the weekend, especially the mid-cycle.
 
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