Need advice for very ill diabetic cat, suspect pancreatitis

Hi, have really learned a lot from this community and am hoping I can get some input for caring for my 12 year old tux, Chimi, until we can contact our vet tomorrow. Saturday morning we woke up and he had vomited. He vomited twice more and the night prior had not finished his food at evening feeding (unusual behavior). He was extremely lethargic so we took him in to our vet. She is aware of everything aside from today's lethargy being pretty extreme and has been working with us to try to get his BG levels stabilized (we have been giving him 2 units Lantus twice a day and it isn't bringing him down into a healthy range, but if we give him more than that at once he becomes hypoglycemic). She took his vitals, which she said were good at the time. She/we suspect he has pancreatitis. She has ordered a SpecfPL and gave us Buprenex, which we have administered.

His BG is currently maxing out the Alphatrak reader. Around noon we gave him 2 units of insulin to see if we could bring his BG down. He perked up a tiny bit, walked around for a little bit but then went back to laying down and hasn't moved much if at all. He is taking water, but no food. We aren't going to give him more insulin since it did nothing for him earlier and he hasn't eaten since Friday evening.

Background: He was diagnosed with diabetes last October and initially responded very well to insulin (Lantus). Recently we have been having trouble getting his BG to stay within a healthy range. It is generally always too high (> 300). We had planned a fructosomine scan for him tomorrow, but we ended up taking him in for an emergency appt with our vet yesterday. He is a high aggression/high anxiety cat (typically we give him 5mg of fluoxetine, which helps a lot). We recently traveled for the first time and had boarded him at a veterinary hospital where they could provide adequate care for him. He had experienced a blood glucose level of 690 while he was in the hospital so they gave him an additional two units midday of insulin and he became hypoglycemic with a reading of 30. This sort of swing has happened twice at home for us, our vet is aware.

My question now is, is there anything that we can do for him if he is having a pancreatic flare aside from administer the pain medication and keep things calm around him? We are so torn up about this, he seems miserable and we're so worried that this may be the end for him. Thanks for any thoughts about anything that we can do and please let me know if I can provide more information. He is literally laying with his head on the edge of his water bowl and has hardly moved for three hours, yesterday he did the same for six hours or more.

 

Hi I'm so sorry to hear about Chimi
I'm going to tag a few members for you to read your post
From what I read , You are only giving insulin every 12 hours correct?
Might have to take him to an ER vet tonight, I'm just worried that he's just laying there not moving

Ladies her kitty really seems in bad shape right

@Wendy&Neko

@Sienne and Gabby (GA)

@Chris & China (GA)

@Bandit's Mom

 

Thank you so much! And that's correct, we typically administer insulin once every 12 hours. Today was an unusual administering because of the high reading even with no food intake for ~36 hours.

 

What do you mean about today's administering?

 

We are considering the emergency vet. Just, after taking him in yesterday to our vet with the same symptoms and being told all vitals were ok and being sent home, we didn't know how much more an ER could do (or what kind of care he needs right now). Really appreciate any input or advice.

 

We administered 2 units of Lantus around noon after getting a "Hi" reading on our glucometer. This isn't a time we typically administer insulin (typically administer at 7am/7pm).

His BG levels are reading the same hours after we did that off schedule administering (no change, still reading "Hi") and we tested the device to make sure it was working. We currently don't plan to administer more until we speak with our vet.

 

Did you give him any lantus this morning also?
Before giving it to him noon when was his last injection

 

No, prior to the dose today midday the last Lantus (2 units) we gave were Friday evening (the last time he ate).

 

I just moved your post over to the Lantus Forum, to see if we can get more eyes on this asap

 

Thank you so much!

 

You're welcome hang in there

 

So sorry to hear your kitty isn't feeling well. Unfortunately, pancreatitis seems to be pretty common in diabetic cats. There are a few active threads right now in this forum for cats that are also dealing with pancreatitis.

If you haven't seen this yet, here is a primer on pancreatitis:
https://felinediabetes.com/FDMB/threads/a-primer-on-pancreatitis.83108/

I personally find this one from IDEXX to be very helpful and easy to follow:
https://www.idexx.com/files/spec-fpl-treatment-for-feline-pancreatitis.pdf

The main things you want to do with pancreatitis is keep the pain and nausea under control and get them eating. For my cat, our treatment is fluids and a Cerenia injection at the vet (for nausea), then ondansetron (also for nausea) and bupe (for pain) at home. Cerenia is an anti-vomiting and anti-inflammatory medication. It lasts 24 hours. You can ask your vet to give you pills to take home with you, my cat just will not take them so I opt for the injection at the vet. Ondansetron is another very good anti-nausea medication that you can give at the same time as Cerenia. And you already mentioned they gave you bupe, which is usually the hard one to get them to prescribe, so that's good It works well for pain.

You also want to make sure Chimi eats. Anything he will eat is fine. For my cat, it's dry food she is usually not allowed to have, tuna, and freeze dried treats. Other people use baby food for their cats. Others may have specific advice for you about insulin dosing, but you really do not want to stop giving insulin, especially if his blood sugar is that high. You can risk ketones especially since he is not eating, and they also feel really crummy in high numbers.