Need help with eating

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jamies

jamies

Member Since 2016
I'm sorry for asking so many questions as I'm new to this and being thatbwikly has been hospitalized twice since he's been diagnosed, this is not going well

He came home from the er yesterday and his appetite is still not good

He is getting 2 units of vesulin twice a day. He is on ant nausea meds and vomiting.

He will only eat the hills dry that he ate there and he won't eat that much

He seems hungry just doesn't want anythung I tried toppers and all sorts of food

Can I try food that is hyou hurt in carbs for now? I don't know what to d

His glucose has been steady in the late 100-200 for four days. I can't take t today I have to go to work ( not until later I mean)

Thanks
 
I've read back through your other threads to see if your kitty was tested specifically for pancreatitis (inflammatory markers, not just general enzyme test) while he was in hospital. I might have missed it but couldn't find a definite answer. You did say that it was a veterinary internist who was treating him. I assume that she'd consider that as a possibility but who knows?

He's getting antinausea meds. Was he also prescribed some sort of appetite stimulant? Cyproheptadine is one that many here have used. I think someone else asked about a possible dental problem. Was that checked when he was with the vet?

His glucose numbers are good the last 4 days. Not eating can create major problems for kitties. They can easily become anorexic because of one issue that makes them feel ill and then the anorexia continues on its own as a separate complication. If he was my cat I'd feed him whatever he wants to eat until he feels better and has had a proper appetite for a good length of time. Yes, it would likely require his insulin dose to be adjusted upward to accommodate that but the not eating seems to be the more urgent problem right now. Let's see what other people here think ...
 
(((Jamie))) - I feel for you with all my heart; you're both going through a real baptism of fire at the moment. I've been through similar and I understand how hard this is to go through.

I agree with Kris; the priority is to make sure Willy gets enough to eat. For now the right food is the food that Willy will eat. As Kris observes above if you can get him back to eating little and often it should help break the nausea-inappetence-further inappetence-further nausea cycle that sets up when a cat has trouble eating.

Cyproheptadine can help with appetite stimulation and it's easier to control the degree of appetite stimulation than with mirtazapine (shorter half-life, milder effect, small (weight-dependent) doses of cypro can be given up to 3 times a day). For information, mirtazapine can induce serotonin syndrome.

I suggest talking again with the vets treating Willy to see if pancreatitis is a problem. Also you really, really, really need to check him for ketones every day to make sure you don't end up dealing with complications like hepatic lipidosis or diabetic ketoacidosis (DKA). (For information, one should call the vet straight away for advice if trace result but any higher than trace you need to get a cat throwing ketones to a vet immediately for emergency treatment.)

Here's a checklist of things I'd want to work on at home and with my vet if my kitty were in this situation:

1. Twice daily check for ketones in urine.

2. Make sure vets run a pancreatitis test.

3. Make sure cat's mouth isn't sore and that it can smell food OK (warm food if necessary).

4. Monitor for clinical signs of discomfort (especially after ingestion of any food) - meatloafing, hiding, lethargy, general nausea symptoms.
Did the vets examine Willy's abdomen?

5. Anti-nausea treatment - Cerenia AND ondansetron should be considered (ondansetron takes a bit longer to kick in than Cerenia but it suits some cats better).

6. Ask about steroid treatment and working the insulin around it to address IBD.

7. Ask about treating on an 'as if' basis for pancreatitis and getting the cat some pain relief (buprenorphine) and also an appetite stimulant (as discussed above).

8. Make sure that constipation is not the issue. (A short course of metoclopramide can help with this.) Poor gut motility can be a problem with some diabetics.

9. Ask for a course of B12 treatment.

10. Make sure kitty continues to be properly hydrated. Ask vet for input on this as dehydration can make a kitty feel worse.

Here are helpful links:

IDEXX pancreatitis treatment guidelines.

www.ibdkitties.net

Even if pancreatitis is not the issue the IDEXX document contains very helpful information on the right treatments to request from your vets for a nauseated cat (nausea being the most common problem in a cat with pancreatitis).

If you can get the right supportive treatments in place it could make things much better for you both.

Sending more prayers for you both. I know from experience how scary and stressful situations like this can be.

:bighug:


Mogs
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And I learned the hard way about what can happen when a kitty becomes anorexic. The outcome was good but I fed my girl via PEG tube for three weeks around the clock while trying to be operational at my work at the same time. Not much sleep for me and lots of worry ...
 
Kris & Teasel said:
And I learned the hard way about what can happen when a kitty becomes anorexic. The outcome was good but I fed my girl via PEG tube for three weeks around the clock while trying to be operational at my work at the same time. Not much sleep for me and lots of worry ...
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I wasn't that fortunate. Our previous vets were like Lisa's (Smoky's mom). They lost one of my cats because they waited too long to even offer an e-tube (hepatic lipidosis). I didn't know as much as I do now. My Danú was an absolute angel on paws and they completely failed her. :(


Mogs
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He has mirtazipne for appetite.

He is on both cerneia and Zofran.(is that what it is called)

Both my vets said no to pancreatitis but I am thinking he needs the special test.

He actually had diarrhea today, could be meds.

His ketones were checked yesterday. I did not today. Trying to feed him before I left was a disaster today. I can check later.

Yes his abdomen was examined plus ultrasound.

The steroids would be an issue with his heart.

I called the internist today, she is in surgery waiting to hear back and I am waiting for the vet.

This has all just been a nightmare :(
 
jamies said:
He has mirtazipne for appetite.
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Mogs has mentioned cyproheptadine above as being easier to dose without risking unwanted side effects. Maybe you could ask your vet for this and say the mirtazapine hasn't been helping much?

jamies said:
He is on both cerneia and Zofran.(is that what it is called)
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Zofran is the brand name for ondansetron so you've got the nausea covered.

jamies said:
Both my vets said no to pancreatitis but I am thinking he needs the special test.
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Maybe you could ask for the SnapfL in-house yes/no test first. The best one is the SpecfL from IDEXX but the blood needs to be sent away. Most of us have suggested you get the actual pancreatitis test in addition to all the blood work that's already been done.

Meanwhile check ketones as often as you can and try feeding whatever he'll eat - canned tuna, salmon, sardines, all meat baby food (no seasonings), higher carb cat food. Warm it slightly, try getting him to lick it from your finger, whatever it takes.
 
The internist said he has no indication of it. none at all and she said that the only other thing they would give is pain meds since he is on everything else.
 
jamies said:
The internist said he has no indication of it. none at all and she said that the only other thing they would give is pain meds since he is on everything else.
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Nausea, wanting to eat but turning away from food, and discomfort are all some of the signs of pancreatitis. I am not sure why the internalist says there is no indication??? If my Tuxie does not "vacuum" all his food I keep a very close eye on him. The minute he starts refusing food is when I start treating for pancreatitis...he has chronic pancreatitis and has flares from time to time.
 
He has one already.

I asked again and again.
The only other meds that he would not be taking that he isn't already is pain meds.
He already received antibodics

He is not crouching in pain like a cat does from it
 
Re the appetite stimulant: you said he's on mirtazapine. Some people on here fond that a different one, cyproheptadine. works better, is easier to dose and has fewer side effects. That's why I suggested asking for a different appetite stimulant.
 
jamies said:
He is not crouching in pain like a cat does from it
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Absence of crouching does not guarantee that Willy may not be experiencing discomfort. Is Willy lethargic/withdrawn at all? Is he sitting/lying in unusual places at all?

If the anti-nausea and appy stimulants aren't working then I think you would be well advised to ask your vet about putting in a feeding tube. Here is information on tube feeding from Dr Lisa Pierson DVM:

Feeding Tubes for Cats

Sending more prayers and :bighug::bighug::bighug:.


Mogs
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Don't let the idea of a feeding tube frighten you. It's not as bad as you might think and has been just what many sick kitties have needed to get them going again. I've dealt with it myself with another cat many years ago. She recovered well.
 
not the insulin.

He is super out of it but not lying anywhere unusual. he had goop out of his eyes. did not look good.

he did eat. he ate last night no problem but then this morning had to nudge but then did.
he ate half a can for my cat sitter. she said his eyes were ok today.

so I am not sure what exactly is going on
 
Hi Jamie,

jamies said:
he had goop out of his eyes ... he ate last night no problem but then this morning had to nudge but then did.
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Any chance he might have a respiratory infection? If he can't smell his food properly that could be a reason for his reluctance to eat. I notice that he responded to a bit of a 'nudge'. If his appetite stalls again and it is a respiratory problem the following can help:

1. Try warming the food or putting some tuna water on top (assuming he can tolerate tuna water).

2. Try to get him to lick a little food from your fingers - the Jacobson's organ might be working better than his nose.

I'm very relieved to hear he has eaten for you. Fingers and paws crossed that he continues to do so. Diabetics are much more vulnerable to infections. If you do suspect an infection then it would be advisable to contact your vet. The combination of poor appetite and infection can significantly increase risk of developing diabetic ketoacidosis. Be sure to check urine for ketones daily.

Has the vet said anything about the lethargy? It's something that needs attention.


Mogs
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I just posted a bone marrow broth in the general community forum that may be helpful. I also have had success with kitties w/upset stomach putting a little & I mean a little toothpick amount of peppermint oil to start on a cotton ball in the vicinity of the cat or a drop on me if I am going to be around them. Peppermint is a natural pain inhibitor & also anti-nausea. I can't stress enough though that it needs to be a therapeutic grade essential oil....lots of EO's are not good quality & can have a lot of junk in them that can be harmful & they don't have to put that on the label. I will disclose that I am a distributor for a brand but only became that b/c of my success in using it with clients I have & animals over the last 5 yrs. I didn't have a local person who could supply me. I follow & have been taught by 2 different veterinarians who use them also. Some animals take to the oils very well...others don't like them at all so it is really important to be respectful of that & always start with a super small amount. Plus their sense of smell is way more sensitive than ours. Peppermint also helps to clear the nose & sinuses in case he can't smell well right now.
 
Thank you. He is a cutie!

He ate today on his own. He seems way more alert.

Thank you for asking!

I will look at the bone broth
 
jamies said:
He ate today on his own. He seems way more alert.
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Very heartened to hear this news, Jamie - for both your sakes! :bighug:

jamies said:
I will look at the bone broth
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Here's a link to the discussion on the Community board:

http://www.felinediabetes.com/FDMB/threads/bone-broth-recipe-for-sick-animals.168980/

Lovely to now have a pic of Willow. Digging the nose smudge! :)

How are you bearing up through all of this, Jamie? Are you managing to get a little rest for yourself?

:bighug:


Mogs
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I am feeling less stressed which will help me not be stressed about shots and testing.
He looks better so I'm not freaking out.

This has been rough but hopefully things will start falling into place.
Thank you all for your help. Makes it a lot easier!
 
I'm really glad to learn Willow is feeling better. Keep us posted on his progress and feel free to ask about anything.
 
So pleased to hear that Willow is looking better - and also that you're feeling a little better too, Jamie. Things do get better.

:bighug:


Mogs
.
 
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