new(ish) concerns with Bubber

[0246]

Hi friends,
It's been a long time since I explored FDMB, but you were an excellent resource just after diagnosis (in 2013) and I'm hopeful someone has insight now.

Bubber is an 11 yr old Maine Coon, diabetic since summer 2013, taking 7.5 units of Lantus twice daily, eating three low-carb varieties of Fancy Feast. He has no other health problems, aside from not having many teeth left after dental work.

On Saturday he acted strangely midday and I tested his bg (he should've been nearing nadir) and it was 34. I immediately fed him dry food, which he ate avidly. He acted normal, and I retested 1 hour after: 50. I fed him again, this time wet shreddy food with gravy (his old favorite). He ate a portion, and then vomited. I retested: 30. I fed him again and watched his bg come back up (84, 150, etc). We held his Saturday evening and both Sunday shots. He was off his food on Saturday; I wasn't around Sunday to see much, but in the evening he enjoyed his dinner per usual. Monday he got his AM inj and ate, though not avidly. He had diarrhea midday, which prompted a vet call. I brought him in: his senior panel labs were all normal, urine normal, fructosamine 415. Exam unremarkable. They gave him a shot of Cerenia to quell presumptive nausea, and Flagyl to stop diarrhea. Tuesday he didn't really want to eat. I got his favorite stinky foods, people foods (he's a nut for roast beef) and meh. He will eat some, but not much. Dry food and dry treats remain tempting. I am syringe feeding meat baby food to keep things in his system, but it's not awesome. He acts like he's in pain - not walking around a ton and when he does it's slightly gingerly, no purring since Friday. I am very suspicious about his teeth, because he seems interested in food but does not want to eat it, but the vet says she checked and his mouth is OK. I can pick him up and manipulate him per normal. His stools are off, but we're feeding him weird stuff and he's on abx.

Vet's next suggestion is imaging: xray and abdominal ultrasound. I will call to arrange those today when they open. Any other suggestions, information, things to think about or rule out? I like this cat more than I like most people (maybe all people). I need to know how to help him.

Thanks,
Jen

 

[BJM]

Possibilities: as cats hide pain well, it could be pancreatitis.
He probably vomited when the dry food expanded. Next time you see too low numbers, use Karo or other syrup which will work fast without filling him up.
How to Handle a Hypo
Maybe he is regaining some pancreatic function and that is why he ran lower than usual.

 

[0246]

I read the primer on pancreatitis and am 90% that's what he's dealing with. We've a vet appt at 2pm to reassess, though they're terrible and it's a 'drop off' visit so all conversation will be via telephone. Awful. We need a new vet. I'm hopeful she will agree to proceed with treatment - fluids, continuing to push feeding, and that she will provide nausea and pain meds. I ordered the zobaline, as well. I think they will push for imaging (xray, ultrasound): is there a clear upside to it, other than putting their children through college with the funds they'll receive?

 

[Anitafrnhamer]

Squeaker just went through a bout of pancreatitis a couple of weeks ago. Vomiting, explosive diarrhea, extremely irritable, low appetite.

I would suggest a snap test. It isn't as accurate as the Spec fPLI but it will be a good indication as to whether the probability of pancreatitis exists. Unless the snap test is incredibly high, which would then necessitate the Spec fPLI to get a more accurate picture of the severity of the pancreatitis, I don't really see the need for the abdominal US and x-ray. I would only proceed with those diagnostic tools if pancreatitis is ruled out.

Just one more thought here, when Squeak had his last flare of pancreatitis, his BG was rather low as well (he has been OTJ and diet controlled for over a year now). We also seem to suffer flare ups of pancreatitis every six months. This one has been the most significant one since dx in July 2013.

 

[BJM]

Should you decide to go vet hunting, check my signature link Vet Interview Topics for some questions to ask.
And go to Google to search for "veterinarian near [your address]" to see candidate vets near you.