NEW MEMBER cat not eating - how does his dosing look?

[Wandering with Sammich]

Hello! My name is Marla and my 15 year old cat, Sammich, was just diagnosed last week. He’d been on prednisolone for a few weeks to try to clear up some sinus inflammation when he started getting lethargy, not eating or drinking, vomiting, trouble walking. Within the span of six weeks, his weight had dropped from 13.5 lb to 10.5. They ran blood work to find his BG was 436. I forget the number of the fructosamine test but that was also high. He started caninsulin at 2 units once a day (as per manufacturer's recommendation of .25mg/kg). I tried to manage at home the first day but he got even sicker, refused to eat, got super dehydrated. Took him back to the vet. When they drew blood, his BG was over 600 and he had to be hospitalized with IV fluids for 5 days while they tried to adjust his insulin dose and get him eating again. They adjusted it up by .01cc until it went too high for a single dose and then split it into two doses. He is now on 1.6 units of caninsulin twice a day.

Up until this morning, he was eating well. AMPS was 413 and he has eaten maybe a small bite in the past hour. (I have another cat, who may have eaten it though as I walked away because Sammich used to be the glutton and I'm not used to making sure he eats.) I haven't given his dose yet. I called the vet but they haven't called back yet.

Should I give up waiting and do a half dose? Do a full dose? I would love to eventually get on a longer acting inulin and get a cgm but that's for another day.

 

[Wandering with Sammich]

I ended up going with a half dose. It was an hour past usual shot time and he still was trying to bury any food I put out for him.

Also, thank you for reading all of this. I feel very overwhelmed with everything right now and really appreciate any insights you all have. The information on this site is so helpful to getting started and understanding what treatment options exist.

 

[Diane Tyler's Mom GA]

On your spreadsheet you have Date of DKA 3-23
If he had DKA you need to add that to your signature. I'll tag a Caninsulin user for you
@Suzanne & Darcy

 

[Diane Tyler's Mom GA]

Hello! My name is Marla and my 15 year old cat, Sammich, was just diagnosed last week. He’d been on prednisolone for a few weeks to try to clear up some sinus inflammation when he started getting lethargy, not eating or drinking, vomiting, trouble walking. Within the span of six weeks, his weight had dropped from 13.5 lb to 10.5. They ran blood work to find his BG was 436. I forget the number of the fructosamine test but that was also high. He started caninsulin at 2 units once a day (as per manufacturer's recommendation of .25mg/kg). I tried to manage at home the first day but he got even sicker, refused to eat, got super dehydrated. Took him back to the vet. When they drew blood, his BG was over 600 and he had to be hospitalized with IV fluids for 5 days while they tried to adjust his insulin dose and get him eating again. They adjusted it up by .01cc until it went too high for a single dose and then split it into two doses. He is now on 1.6 units of caninsulin twice a day.

Up until this morning, he was eating well. AMPS was 413 and he has eaten maybe a small bite in the past hour. (I have another cat, who may have eaten it though as I walked away because Sammich used to be the glutton and I'm not used to making sure he eats.) I haven't given his dose yet. I called the vet but they haven't called back yet.

Should I give up waiting and do a half dose? Do a full dose? I would love to eventually get on a longer acting inulin and get a cgm but that's for another day.

@Suzanne & Darcy

 

[CORKY]

On your spreadsheet you have Date of DKA 3-23
If he has DKA you need to add that to your signature. I'll tag a Caninsulin user for you
@Suzanne & Darcy

Welcome to FDF, you are in the right place

 

[Wandering with Sammich]

Thank you! I will add the DKA tag. I was not sure if I needed some sort of official diagnosis. Vet never tested for anything extra and it is my best guess based off of symptoms

 

[Bron and Sheba (GA)]

Hi and welcome.
If your kitty is post DKA there are several things you need to be doing to help him recover.
If he is not eating well, please ask the vet for one of the antinausea meds listed below.
Don't skip any doses of insulin.
Here is the list of things you need to address to help Sammich

• you need to give one and a half times as many calories as he normally eats. Offer snacks every couple of hours during the day and evening as well as the 2 main meals. Food is like a medicine and helps keep ketones away. If your kitty won’t eat the low carb food, feed him whatever he will eat as eating any food is better than not eating,
• Don’t skip any doses of insulin as insulin helps keep ketones away. If the BG is not high enough to give the dose…stall, don't feed and test again in 20 minutes and post and ask for help.
• Test daily for ketones. Put the results of the tests into the remarks column of the SS so we can see. Please report any trace ketones at all. To test for ketones you will need to buy a bottle of ketostix from a pharmacy. Please get these asap as it is very important we know if ketones are present
• Give antinausea medication if needed such as ondansetron or cerenia. Nausea is very common in post DKA kitties and it needs to be addresses immediately
• Give appetite stimulant if needed after the antinausea medication
• Give extra fluids. If kitty will tolerate warm water in the food, put a teaspoon into each snack..
• Ask the vet about subQ fluids
• Set up a spreadsheet and test the BG frequently
• Post daily with updates and ask for help as often as needed.

 

[Kobe (Dean and Lesley) MO]

Up until this morning, he was eating well. AMPS was 413 and he has eaten maybe a small bite in the past hour. (I have another cat, who may have eaten it though as I walked away because Sammich used to be the glutton and I'm not used to making sure he eats.) I haven't given his dose yet. I called the vet but they haven't called back yet.

Should I give up waiting and do a half dose? Do a full dose? I would love to eventually get on a longer acting inulin and get a cgm but that's for another day.

Sorry we didn't get his answered in time. It's good that you didn't skip the shot.

Give antinausea medication if needed such as ondansetron or cerenia. Nausea is very common in post DKA kitties and it needs to be addresses immediately

If Sammich is not eating well, can you get these anti-nausea medications from your vet? how is his appetite today?

Give appetite stimulant if needed after the antinausea medication

If your cat needs an appetite stimulant, many of us use Mirtazapine Topical Ointment, so you could ask your vet for that too.

 

[Christie & Maverick]

I would expect that the vet would have told you if your cat were in DKA, and while your cat was hospitalized, monitoring ketones in blood and or urine and working to reverse high ketones if present, and addressing electrolyte imbalances and administering IV fluids.

Pancreatitis comes to mind, particularly with some of the symptoms of sudden inappetence, lethargy and increased blood glucose levels. Here is the primer on pancreatitis.

If you are finding that he is licking his lips and/or eating a little then walking away, those are often typical signs of nausea. As Bron mentioned, you can treat that with anti-nausea meds like Ondansetron or Cerenia (Maripotant). And I second getting ketone test strips and monitoring for ketones. Even if he didn’t have DKA when he was hospitalized, he is currently at higher risk of developing ketones, particularly if he has some underlying infection/inflammation, added to that current inappetence (not eating enough calories) and not enough insulin.

You may find a few things from this list on How to Stimulate Kitty’s Appetite helpful. Hoping his appetite improves quickly, I know how stressful it can be when a cat who is usually very food-motivated stops eating like they usually do.

 

[Wandering with Sammich]

Thank you so much for this.

I have been using a multi urinalysis strip every morning and will start recording the ketone portion of the strips. The strip I did last Saturday read: 5(0.5)+- for ketones. This morning and yesterday morning there were no ketones.

His appetite came back in the afternoon and has been great so far today! I have spent years trying to get him to lose and keep off weight so I never imagined I would be begging him to eat.

As for a vet, here’s where our situation gets complicated. I travel full time, moving every week or two usually, and the vet we were seeing was down in Mexico, so they can’t prescribe for me now I’m back in the States. It’s hard to get seen promptly by vets as we travel as they are often booked far out or not accepting new clients, so we end up utilizing emergency clinics which help for one off issues but they are reluctant to prescribe anything long term. I was going to make a post later to ask if there are any vets people typically recommend, especially if they might consult online for chronic non emergency things.