New Member - Christina & Kitty Cat - 9/13/20

Kitty Cat has been throwing up everyday for the last 3 days, twice within an hour early this morning, didn't eat breakfast.

Kitty Cat (M/8yo) was diagnosed with diabetes on 9/1/20 and I started insulin on 9/4/20. This forum has been super helpful while I try to research everything at home.

He used to be overweight at 16lbs, and suddenly dropped to under 7.5lbs in the last few months. I missed all the warning signs thinking it was good he was losing weight and drinking A LOT of water. Then he wasn't eating all his food and I took him in to get checked out at a new vet. I have no pet insurance and I'm currently unemployed due to COVID so the price and news really hit me.

He's currently on 1 unit of Lantus 2x a day (9am/9pm) and eating Hill's w/d wet food portioned for an ideal weight of 10lbs. After reading through this site, I made sure to get a monitor right away and test at home. He seemed to start getting better though his numbers were still all over the place. He wasn't having diarrhea anymore, he started eating more, took a few sips of water after not drinking for days, never vomited before.

Then 3 days ago he started vomiting, his poop got super hard and dry, he was constipated, excessively cleaning his butt, but still eating so I continued insulin as usual. This morning at 6am he vomited, and then again at 7am. Now he won't eat so I'm skipping his 9am insulin.

Is vomiting normal or a side effect of the insulin? Do I need to take him to the emergency hospital? (It's Sunday so vet is closed.) I'm so worried about him but also don't have the funds to go to the hospital every time something happens so I'm not sure what to do now. Any advice/support appreciated!

Concerns: Vomiting, constipation, didn't eat breakfast

Tried putting this spreadsheet in my signature but it kept saying it was spam so posting here:
Kitty Cat's BG & Insulin Spreadsheet

 

Christina -

If your cat has been unable to hold food down for 3 days, you need to get Kitty in to see a vet. There are several other housekeeping issues but they can wait. When a cat doesn't get enough calories, there's a risk for liver problems. Likewise, if there is some other medical issue, the risks for diabetic ketoacidosis (DKA) increase. What I can tell you is that this is not a typical reaction to insulin.

If your cat is, in fact, constipated, the vet may need to give an enema or make some other suggestions. If your vet isn't open, you may need to get Kitty seen at the emergency vet.

 

Welcome to FDMB NO insulin should not cause Kitty Cat to vomit. Have you been checking for Keytones? This does not sound good. If not I think you need to take him to the vet ASAP

 

Sorry to be so blunt. sigh I hope you and Kitty Cat are able to go to a vet.

 

I found out my vet group has another branch with Sunday hours so I gave them a call. The dr is currently in an appointment but will call me back after. I'm assuming it was a tech that answered the phone because she said she's not very experienced with diabetes so can't give advice, but will have the dr call me back.
Friday 5pm he drank a little and then threw up mostly water (it was clear). Saturday 3:30pm he threw up mostly brown liquid. He was was fine to eat dinner at 9pm and breakfast at 9am afterwards. It's just today that he threw up mostly solids and won't eat. It's now 2 hrs past breakfast and I still can't get him to eat anything. Is it okay that I skipped his insulin? His bg was 369 at 6am right after the first time he threw up. Then 414 at 9am when he's supposed to get his shot. So I'm worried about it going higher but also don't want to give insulin if he has no food in his stomach.
I haven't tested for keytones before. I will buy the strips now. Will any strips do? Looking at this one from Amazon.

 

I'm not familiar wit the strips Have never needed them (knock wood) but this will take your question to the top of the list

 

@Sienne and Gabby (GA) IS this a 911 situation?

 

You should be able to get ketones test sticks (I used Ketostix) from any human pharmacy. The answer as to whether it's OK to skip insulin depends on whether he has ketones. Insulin does more than combat the carbs in his food. A half dose is typically safe - it's what diabetics undergoing anaesthesia and cannot eat can usually get. Plus he's quite high. However, with Lantus, if you shoot a couple hours late, it means your next shot is also later. You can get back on schedule by 15 minutes a shot or 1/2 hour once per day.

May I ask why the w/d food? It's very high in carbs. Not a good choice for a diabetic. As long as there was no other medical reason for the w/d, there are lots of cheaper commercially available foods that are low carb and suitable for diabetics. What was he eating before? Also wondering if a fast food transition upset his tummy.

 

Thank you Wendy

 

I say no, especially since it sounds like he ate last night. It is time to discuss with the vet, and sounds like that is going to happen.

Another post for you: Suggestions on How to Stimulate Kitty's Appetite

 

I’m with Wendy. Most of us feed our diabetic cats fancy feast pate which is low in carbs and very good quality. Most vet prescribed foods are high in carbs and have nothing special about them other than the price tag. When you do talk to the vet, ask about anti nausea meds. If he’s nauseated, he won’t eat without meds like Cerenia or ondansetron. I’d also be a little worried about dehydration from all the vomiting. This happened with Minnie a lot and now we know it’s because she has IBD in addition to the diabetes so he may have another underlying condition as Sienne and Wendy suggested and a trip to the vet may be necessary.

in the meantime, can you try giving him some baby food? Minnie would almost always eat that even when she wouldn’t eat anything else. Added bonus is that it has a lot of moisture in it. Gerber is a good brand. Something like their chicken or turkey. Off any other brands, make sure it has no onions or any spices added. It should be just the meat.

 

Thank you

 

Thanks for all this info everyone! It helps to calm my nerves a little since I was a wreck this morning.
I asked the vet the day of the diagnosis to give a food recommendation and she prescribed hills w/d either dry or wet (I chose wet), and 2 other prescription options. But I notice it has flour and corn. I wanted a grain free diet since thats what all of the internet said to do, but my vet prescribed this food and I went along. My cousin is currently studying to be a vet and also had very strong opinions about keeping him on the prescription diet and NOT going grain free.
He was previously eating Purina cat chow naturals dry food which contains corn and rice. I made the switch on 9/4 as soon as it came in the mail. I didn't ease him into the new diet as slowly because I thought this new food much be so much better. But he still tries to get into the cabinet where his old food is.
Vet gave him Cerenia the first visit for nausea, but he hasn't thrown up before then. But so far since I got the diagnosis 2 weeks ago, he's thrown up I think 7 times now. (4 of those in the last 3 days)
He ate as normal up until this morning. He's drinking more and more water today which I'm not sure if I should be happy or concerned. He's staying close by to his litter box today (not in it, just a few feet away) which is odd for him but he's been trying to poop for hours with little luck. He took a few licks of food so far.
Since it's been almost 4 hours since he was supposed to get his first shot, I'm assuming I should wait until his nighttime shot.
Vet hasn't called yet so I'm just stuck waiting for now and keeping a really close eye on him.

 

Hi Christina,

I see you've already had some good suggestions from other members regarding testing for ketones, DKA, etc.

High ketone levels (and possible concomitant dehydration) can be one cause of nausea.

Constipation is another possible cause of nausea, vomiting and reluctance to eat. Given that Kitty Cat has been having problems with constipation very recently, my best suggestion to you is to get him checked out by a vet ASAP to see whether there is a stuck stool or any other obstruction in the gut. If the vet finds no obstruction or if they administer an enema to 'free things up' then a couple of days' treatment with metoclopramide (Reglan) can help restore normal gut motility. On top of that, you will probably need to start some form of preventative treatment for the constipation (NB: do not start this before the vet confirms that there are no obstructions in the gut!). The website felineconstipation.org has very helpful information.

Another possible cause of nausea and vomiting may be pancreatitis. If only to rule it out, when you take Kitty Cat for a check-up, I suggest you ask the vet to run an on-the-spot Snap fPL test for pancreatitis. The following resource is very helpful:

IDEXX Pancreatitis Treatment Guidelines

The above document also contains information on all the standard treatments for cat nausea and appetite stimulation. These can help a cat to eat better, but if constipation is present then none of these treatments tend to work until the constipation has first been addressed. Should pancreatitis be present then pain relief needs to be prescribed alongside anti-nausea and appetite stimulant meds.

Note: Some vets prescribe metoclopramide to treat nausea but it does not provide any noticeable anti-nausea benefit in cats because they have very few of the receptors it targets - see the IDEXX document above. Ondansetron and Cerenia are appropriate treatments for nauseated felines. Famotidine can also help with hyperacidity in the stomach (usually the cause of cats throwing up foamy, watery vomitus after several hours without any food). Lots more helpful info here:

Nausea, Vomiting and Inappetence - Symptoms and Treatments

Bearing in mind that Kitty Cat didn't get any insulin this morning, is spending at least part of the day running in fairly high numbers and is having difficulty eating, as a safety precaution I'd recommend testing for ketones as soon as possible: should ketones be present then they need to be addressed straight away, and higher levels constitute a medical emergency. You should be able to pick up urine ketone test strips locally from Walmart or any pharmacy. Here is helpful information:

Testing Your Cat for Ketones

Tips for Collecting Urine Samples

The sooner you can grab a test, the sooner you can either breathe a sigh of relief or get prompt, appropriate help for Kitty Cat.

I hope he feels better very soon.


Mogs
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PS: Be sure to keep us updated!


Mogs
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Getting test strips at the pharmacy now! Hope he pees soon with all the water he's been drinking.
I didn't see lab results after the first visit but I checked back at the first email from the vet:

"There are changes in Kitty Cat's bloodwork that are consistent with diabetes: Kitty Cat has high blood glucose, and there is glucose in his urine, as well as ketones, which are more concerning. His high liver values could be due to his diabetes or another pathology (eg. hepatic lipidosis or other disease). He has slightly low neutrophils, a type of white blood cell; decreased neutrophils can be seen in infection/inflammation/other reasons."​

So it's mentioned that there were keytones in his urine at the time of his test which was 8/31 (Results came in on 9/1). The vet hasn't asked to see him in person again after the first visit. Was something supposed to be done about the keytone situation? What do they do when there are keytones present?

 

Go with your gut (and the internist) - stick with low carb and grain free. Your cousin has no doubt had lectures from the pet food manufacturers who are more than happy to provide the "expertise" to teach up and coming vets on nutrition. If you don't want to feed Fancy Feast (I didn't), there are lots of other options. This food list is one source to look at - you want food with carbs under 10%. Actually the website catinfo.org where I liked that list is a good read - written by a vet nutritionist.

OK, thanks for that update on ketones. You do want to test at least daily for a while and not skip insulin if at all possible. Even if it means feeding higher carb food. You need to get something into him. Try to water down his food as well, to help flush out any ketones. Sorry but more reading for you: Ketones, Diabetic Ketoacidosis (DKA), and Blood Ketone Meters and this one is a good one just for overall background. What is Feline Diabetes?

 

And one more thing, trace ketones are manageable at home, above that means a vet visit. If he does have an infection, that needs to be treated as well.

 

One thought for consideration -- the W/D may not be agreeing with Kitty. She could be having an allergic reaction. It's truly junk food when it comes to ingredients. FWIW, my diabetic was very sensitive to beef and anything with gluten. She'd puke it right back up.

I would try to see if Kitty can hold down some baby food -- stage 2 of either Gerber or Beechnut. The ingredients are a protein and broth -- no veggies. It's gentle on the stomach. Otherwise, pick any of the foods that are below 10% carb from the food chart that Wendy linked.

 

He's eating!!!! I just tested him again, BG is 359, down from 414 5 hrs ago when he usually eats breakfast and gets 1 unit insulin). Should I give him 1/2 unit now while he's in the eating mood? I don't actually have half unit lines on my syringes.

Do you mind explaining this more, I'm a little confused. If I give him insulin now (5 hours after it was supposed to be), does his next dose need to be 12 hours from now, and each shot after that gets moved back 15 mins until it goes back to the normal 9am-9pm schedule?

 

Getting Fancy Feast Classic Chicken Pate now which he has had before and liked. Hopefully that will get him to eat some more today. Shame I have all this prescription food left that was so darn expensive, but I don't want to keep giving it to him if it's not helping the situation.

 

Has Kitty Cat managed to poop yet?


Mogs
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he popped out 3 lil spheres since this morning, a few hours apart from each other, VERY solid.

 

return the food to the vet and get your bill paid down or money back. smh Tell him kitty refuses to eat it.
or donate it to a local shelter.

 

Definitely get your money back from the vet on the food. The fact that he's eating is fantastic though!

As far as the shot schedule, maybe an example will help. It's best to give Lantus as close as 12 hours apart as you can. Say your shot time is 7AM/7PM. If you end up shooting late at 9AM (as an example), then you can do the PM shot at 8:45, then the next morning at 8:30. Or you could shoot at 9PM tonight at 8:30 tomorrow morning. Then the shots after that can be moved up the same way and it'd take you 4 days to make up those two hours.

As for tonight, if you are 5 hours late now, you have two options. First is to give the full dose now (or soon), and then go back to your regular schedule tomorrow morning, so about 19 hours later if my math is right. Or you can wait until tonight and give the shot at a time that suits you. Since you've gone more than 12 hours without a shot, you can shoot earlier if you want. Whether or not you are seeing ketones might influence the decision.

1/2 unit marked syringes are best. About 2/3 of the way down this Sticky Note on Insulin Care and Syringe Info from the Lantus forum, you'll see descriptions and brands of popular syringes that have half unit markings.

 

I think a once-over by the vet would be a very good plan. Then you'd be able to try something to help the constipation. (NB: It's not safe to start home treatments for constipation until a kitty's been examined by a vet to make sure there's no obstruction in the gut.)

With the liver issues and inflammation flagged up from the last vet work-up those, too, suggest it could be worthwhile checking whether pancreatitis might be an issue.

How's Kitty Cat's hydration?






Mogs
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@Wendy&Neko -

Could you help Christina with advice on dosing if Kitty Cat switches quickly to FF low carb from the Hill's w/d? I see from his SS that he has been in fairly high numbers but such a diet change would represent a significant drop in carb load.


Mogs
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THANK YOU FOR ALL THE READING MATERIAL EVERYONE! This is all so helpful, I really appreciate it and will be going over everything as quickly as I can.
I keep finding him at the water fountain today so hopefully I get a good pee sample soon.
I ordered the food from Chewy so I doubt the vet will help me out. I also bought First Mate Chicken as a backup after watching this video but I see from the chart that it has 19% carbs. I haven't opened it yet so I'll try to return that one.
I looked up hills w/d in the chart and it says 25% carbs, but on hill's website it says 6.2% so I must be reading this wrong?

 

This is totally not what I learned when I was watching videos on how to do this!

• Never shake or roll your vial, cartridge, or pen.
• Do not inject air into cartridges or pens. Cartridges and pens are designed to work on a negative pressure principle.
• If you draw up too much insulin in the syringe... squirt excess either into the air dramatically like they do on TV or into a paper towel... anywhere but back into vial/cartridge/pen. There is a silicon coating inside the syringe. It may contaminate the insulin vial with silicon.

I watched this video on preparing a syringe with insulin which directed I roll the vial to mix and warm it, inject air into the vial, and re-inject the excess insulin into the vial.

I'm so stressed that I'm doing everything wrong for him. I'm hoping that being on here now and getting all these second opinions will help save him.
He's really chowing down on the fancy feast, the cleanest bowl I've seen in a long time. Still waiting for him to pee so I can test for keytones. Also still no call back from the vet.

 

Thanks for this video! Did the 2 tests and he seems normal. Though he just ate so I'm not sure how accurate the gum test is. The vet did say he was dehydrated when she saw him on 8/31 though and he wasn't drinking much/at all until today.

 

yes please! Any advice is greatly appreciated. He didn't really want to eat the w/d today, but as soon as I opened the FF can, he went crazy. Though I feel like he always likes whatever's "new" + the sound of a fresh new can. I'm giving in small spoonfuls right now but he's almost done with a 3oz can already. Should I be mixing w/d with FF for a gradual change or just stick with FF since he seems to accept it more already?

 

Well if you mix the two it will bring his carb load down slower. Might not be a bad idea but wait for more replies .

 

The video you watched on injecting a cat was for for Prozinc insulin - not Lantus.

Chewy should take back the food you bought from them.

With possible ketones in the picture, I'd rather stick with 1.0 unit for now and see what happens. It's a fairly typical starting dose for a cat, especially with an ideal weight of 10 lbs.

As for food, I think I'd stick with the FF for now. Probably less ingredients. Make sure to add a spoon or two of water to the food, constipated cats need lots of fluids to soften things up.

 

Ahh thank you so much!! I need to be more mindful that there are different types of insulin. I will contact Chewy, if I can return it, I'd be so happy. Every dollar is counting here. I have been adding water to his food so hopefully results show more over time. Still waiting for him to pee...

 

The 6.2% figure is the carb content 'as fed'. When comparing foods here the % of calories from carbs is used in the chart. The Hill's website 'dry matter' % is a close-ish approximation to the figure in the food chart.

On some food manufacturer websites they list the dry matter % for macronutrients such as protein, fat, and carbs. The dry matter values are used when comparing foods rather than the 'as fed' values because the moisture content varies from food to food.

Glad that Kitty Cat is eating. Fingers and paws crossed over here that he'll keep it down this time!


Mogs
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@Wendy&Neko - Thank you!


Mogs
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Thanks so much for this explanation!

Just got off the phone with the vet. I mentioned everything going on and she thinks it might just be that he's not agreeing with the new food. I said I gave him FF and he ate it right up after refusing the w/d. Asked if it would be okay to continue with the FF but as expected, she called FF "junk" and advised trying a different prescription diet. Sorry, don't mean to bash the vet, just sorting my thoughts here. My gut is saying not to listen. Just to be super duper sure, this is the fancy feast classic chicken we're all talking about right?

Vet also advised $530 ultrasound on Wednesday (today is Sunday) which I was going to get eventually anyway, have just been holding off because of the cost. + $45 recheck exam. They said I have to bring in my own insulin for them to administer. Instructed 1/2 dose in morning with small amount of food, and then bring him right after to keep for the whole day since he can't eat before ultrasound. Not sure what the misc item is. Breakdown here.

Family is telling me to hold off on the ultrasound to see if he gets any better with some more time on the insulin. Would it be the worst thing to wait if he seems to be getting better?

 

Again sorry but the ONLY thing special about that "script" food is the price. Marketing agents working for huge companies that make this stuff have done and ARE doing a marvelous job of selling it to every vet that graduates from vet school. UNLESS your cat has IBD or similar issues I would never TRY to feed it to my cat. I was sold 12 cans for 40 bucks and Zoe wouldnt go near the stuff. If they wont eat it what good is it??? I have even heard (not confirmed) your vet gets a kick back for every can they sell.

OK OFF SOAP BOX... for now
j

 

You can always tell your vet your cat won't eat vet food and you don't like the quality of it. There are options to Fancy Feast, though many people here feed it because it's cheap and low carb. The classic pate you linked is fine. I wouldn't even feed vet food for IBD! Too many of them have gums which many IBD kitties can't handle. My one exception to vet foods is a/d or royal canin recovery which are good when you need to assist feed.

Not sure why you'd have to take in insulin. Anytime my cats have had an ultrasound, they don't eat after midnight and get dropped off in the morning, and get scanned then and home in time for dinner, if not within a few hours. My current vet (pre COVID) let me be there while the ultrasound was being done, to reassure kitty. So we'd be there less than an hour. Neko actually had ultrasounds when she'd eaten food. The difference is whether they need to do anaesthesia. When I was there it was never needed. Neko did need some sedation if I wasn't there, but never full on anaesthesia for an ultrasound.

 

Vet said to bring him in the morning after a little bit of food and then they'll have to keep him there for a while. I asked how long and she said it depends on when the specialist comes in to do the ultrasound so I'm pretty confused/nervous about it. I'm not sure if they're planning on just keeping him in his carrier until whatever time the specialist gets there.

Update: Kitty Cat projectile vomited probably everything he ate and drank today, slipped in the vomit and flipped over, landing in his vomit. I rinsed him down which he didn't appreciate but I'm just panicking now. I'm terrified, I'm sure he's also terrified. Just checked BG and it's 343, not unusual for him. But now I know he's not going to eat dinner. Won't even take a treat after bg check. I will give insulin as normal since his number is still high. Is there anything over the counter I can give him for nausea??? I will call vet as soon as they open tomorrow to try to get him checked out.

 

Poor Kitty Cat, poor you. That ultrasound is sounding like a good idea. The best nausea meds need a vet prescription (cerenia, esp. if vomiting, and ondansetron). You could try slippery elm bark to see if that settles him. https://felinecrf.org/holistic_treatments.htm#slippery_elm_bark

 

FINALLY ABLE TO TEST FOR KEYTONES. Photo here. I think it's closest to "small". Vet said it was "traces" before so it's getting worse? He also pooped a little. I really thought he was getting better until today so I'm so scared and frustrated now. Hoping vet sees him right away tomorrow. If they wont see him tomorrow, I'll go to a hospital.

 

Did you hold it exactly 15 seconds before checking against the scale? It can darken with longer time.

Insulin tonight should help.

 

yes, counted 15 seconds. It looked the tiniest bit darker than small, but still not in the moderate range.

 

anything past trace amounts is a vet visit. Let them know about this test.

 

Is everything okay?

 

Update: He's at the vet now, they redid his blood test, gave him fluids and anti-nausea. They suspect DKA and want him to go to a hospital which I am willing to do, but dr. warned it can cost $2k+. Does anyone have experience with DKA? My family is saying he's suffering and I need to consider putting him to rest. But if he has a fighting chance, I will do everything I can. He was still so energetic this morning.

 

There have been many here. He can recover from it. Maybe DCIN can help with the expense.

 

If the suffering can be alleviated then its not suffering. Hes sick sigh... if you are willing to spend the money then they should have no say.
I can blow through 2000. in one trip through a catalog .

 

Hi Christina,

A cat can get very sick when it's in DKA. It is treatable in a hospital setting and a cat can make a full recovery.

The hospital can provide intensive care for Kitty Cat. They can give IV fluids to help flush out the ketones and to properly hydrate him. With intensive monitoring they will be able to safely administer insulin and dextrose to get blood glucose levels back into a better range, and correct Kitty Cat's electrolyte balance, thereby restoring normal metabolic processes.

Keeping you both in my prayers. Please keep us updated.

(((Christina and Kitty Cat)))




Mogs
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DCIN = Diabetic Cats in Need.

@tiffmaxee - Have you got the contact details?


Mogs
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I was also tracking his weight and he lost even more weight this weekend, probably from all the vomiting. Vet is also concerned that his numbers aren't going down. He was 223 this morning but vet said he's in the 400s now even though he got his morning insulin.
All the reading points to DKA being treatable so of course I want to try everything before ever making that kind of decision to put him down. He's only 8! And he was so lively this morning waiting to be fed. I'm working on applying to jobs so I can keep affording this treatment for as long as he needs. Luckily have some savings. The vet just estimated $2k but it all depends. I just called the hospital and it's $210 for a consultation and then they'll figure out the costs from there. Waiting on the vet to call me back so we can arrange it.
Just sobbing over here and trying to get some rest. It felt so weird to leave the vet's office without him.

 

No. Chris does. Tags not working either on my end.

 

I sent a PM in the hope that Chris might get an email notification.


Mogs
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https://dcin.dreamhosters.com/

For now, ignore this bit other than the CareCredit option. They go over and above to try and find the money to help.

If your cat is in the middle of a veterinary emergency, please see the Emergency Veterinary Assistance page. NOTE: Due to our current financial situation, as of July 13, 2019 we are no longer able to support emergency veterinary assistance. If you have not yet applied for CareCredit, we encourage you to do so to see if that can help.

 

(((Christina and Kitty Cat)))


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Hope the vet can sort out the constipation problem too, and also do the pancreas test.

Sending more prayers...

(((Christina and Kitty Cat)))


Mogs
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Looking at care credit but it seems like it's justajust credit card? I've been putting the bills on my credit card already and my savings should be good to cover everything so I think I'm alright. Too bad there's no retroactive medicaid type of thing. I got that last year when I was in the hospital suddenly but I'm no longer on medicaid.
I feel bad using funds that could go to someone more in need. I will just make sure to work hard to earn the money.
I'm sitting outside the hospital now waiting for them to call. It's been 45 minutes already and it's all so nerve wracking not knowing what's going on or off they're even looking at him. Primary vet said he'll likely need to be here for a few days so I made sure to give him as much love as I could through his carrier before handing him off.
Thanks everyone for being here and caring about my baby and helping me through it all. Praying for the best now.

 

Yes, definitely will make sure they check for pancreatitis.

 

The SNAP test for pancreatitis will just give a positive or negative. The SpecfPL will give a score so better because the SNAP won't be positive if in the gray zone. Losing that much weight so fast can cause fatty liver. Kitty can recover from that as well.

 

Tagging a couple people who have had kitties in DKA and get over it. @AliceMeowliss&Cassandra @Sienne and Gabby (GA)
Sorry, I know there are more, but my brain is a fog like the smokey air here.

 

Thank you! Hospital just called and he's going in for an ultrasound now. They highly suspect pancreatitis and liver infection so just need to confirm. If there's nothing unexpectedly worse going on, he'll be admitted and stay here a few days. Wish I could hold him the whole time. You guys give me hope!

 

Awww more prayers on the way!

 

Poor kitty cat & you - you have been through a lot these few days. Hugs to you both from me & my 3 kitties
Thoughts are with you both. You're doing an amazing job for him.
Gill

 

You are holding him - in your heart! He knows how very much you love him.

(((Christina and Kitty Cat)))

More prayers on the way...




Mogs
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Give us an update when you are able.

 

When Gabby was diagnosed she had DKA, pancreatitis, and hepatic lipidosis (fatty liver from not having eaten -- my kitten was snarfing down her food behind my back although, she didn't have much of an appetite). I had 2 vets preparing me for the worst. She pulled through. I was probably a pain in the neck with calling the ICU but it made me feel better to hear that her labs were improving. I'm keeping my fingers crossed for Kitty.

 

Update: I got to take him home tonight!!!!!! They did the ultrasound and they said he DOES have pancreatitis and GI inflammation, BUT it's not severe and he's not in DKA "yet" so he wasn't required to stay overnight which would have cost me $3k. No blockages. He did poop (no blood) and pee when we got home! Some signs of aging in his kidneys (he's 8) and slightly elevated liver values.
They gave me some pills to take home: ondansetron - once every 8 hours & famotidine - once a day.
He got fluids and Cerenia from the primary vet today and did not throw up, but hospital said to also give him the pills tonight. His dinner time is in half an hour and he's definitely hungry so hoping he eats normally and keeps it down.
I did another keytone strip today and it's a lot lighter, I think between negative and trace.
They said if he keeps his food down, great, resume as I was. If not, I'll have to bring him back in to the hospital tomorrow. She said if he can keep the food down and gets insulin on the regular schedule, the other stuff will hopefully go away on its own.

 

Fantastic update!!!

I really like ondansetron, plus it has no flavour so I'm easily able to hide it in a pill pocket. Paws crossed his food stays on the inside this time.

Now we know that Kitty Cat can't skip his insulin.

 

Hmm, he's a poop machine now. Maybe he just needed the fluids today to push everything out.

I stuck the pills in the first bite of dinner and he ate it right up no problem.
Wendy, for the Ondansetron when it says every 8 hours, do you know how strict that needs to be? I just gave him one with dinner and it's 9pm so the next has to be at 5am or is there some wiggle room?

Yes! I feel so bad I skipped it yesterday morning because he was at 414. I was just so concerned about him not having it with food. But I now know to always give insulin at the regular time unless he's under 250. The hospital last night actually said to skip this morning's insulin, but the primary vet this morning said it was okay to give him since he did eat breakfast normally.

 

Question about food:
With fancy feast, should I follow feeding amount instructions on the can, or does it need adjustment because he's diabetic? He lost weight again so he's under 7lbs now. When the vet prescribed w/d she said to feed for an ideal weight of 10lbs. FF says 1 can per 3-3.5lbs, so I will feed him at least 3 cans a day.
Question about treats:
I also got PureBites chicken breast treats and Greenies oven roasted chicken flavor dental treats .Vet said he has gingivitis and a lot of buildup but he's not strong enough to go under anesthesia for a cleaning right now so the treats could help in the meantime. How would this affect his main food amount? I see it says "adjust amount of main meal to compensate for calories delivered by treats".
I'm getting him to drink water!
When I mixed w/d with water, he wasn't really into it, but with the FF, he's licking the bowl dry. I also threw a treat in a bowl of water which forced him to drink the water for a bit before finally fishing the treat out.

 

How big is the ondansetron dose, and how much does Kitty Cat weigh?

We say it's OK to shoot over 200, and we will often suggest lower for new people if the cat has ketones.

Give to effect. If you know what his ideal weight it, use the scale to tell you if he needs more or less food. With ketones recent, I wouldn't worry about feeding a little extra for the next while. I never go by amounts to feed on the can, but rather by the calories. If he needs to gain, also don't worry about the treats. Not sure on the carb amounts for the Greenies though...

 

Sorry, saw you said he's 7 lbs. Ideal ondansetron dose is 1.5-2 mg per dose to start. You can give the next one about 1/2 - 1 hour before breakfast. You don't have to be so strict if later.

 

Prescription is 1mg (1/4 of a 4mg tablet) every 8 hours. Sorry I though he was below 7lbs when I weighed at home but it's probably not accurate. According to primary vet he's 7.24lbs, according to hospital, he's 7.45lbs (few hours later). 2 weeks ago primary vet said he was 7.46.

I noticed it had grains but I was hoping just giving him 2-3 a day (bag says 8 for 10lbs) wouldn't hurt and it really helps getting him to drink water.

 

OK, he's being dosed on the low side for his size then. That gives you some wiggle room.

 

For Ondansetron, I got 20 mg total so less than a weeks worth on this dosage but hopefully he won't need it after that.
The Famotidine dose is 4mg (1/4 of 20 mg tablet) once daily until gone and I have 100mg total so will last 20 days.

Summary update before I try to catch some much needed sleep in case I suddenly need to be alert in the middle of the night:
-a little while after we got home, he pooped a whole bunch, good consistency, no blood!
-also peed, hospital said his bladder was large but was probably just holding it in. tested for keytones and we're in the negative-trace range, better than yesterday's small. I'll keep testing everyday and mark it in a new column on my spreadsheet (this spreadsheet is amazing, bless this community, even my vet said wow)
-he ate 2 whole cans of FF for dinner (1 can in the morning so 3 cans total today). I'm a little worried about him eating so much and possibly throwing up again, but I'm praying all the anti nausea stuff will keep it down for real.
-snuck a bunch of water into tonight's dinner and he had no issues with it
-sticking with 1 unit lantus

I don't want to celebrate too soon but I did feel a lot of relief when they said he didn't need to stay overnight. Today was really hard for us so thanks again everyone for all the love and support. Goodnight everyone and all the fur beans <3 Will keep you updated

 

Celebrate the small victories Relief IS a victory.

 

Morning update! He didn't wake me up this morning but instead I had to wake him up which concerned me because usually he's up way earlier and swatting at my face to feed him. Checked the whole apartment, no vomit anywhere. He peed twice during the night. Considering the amount of water he had with dinner, I feel like this is okay. Checking for keytones will become part of our nighttime routine now.
Gave him the pills with the tiny bit of leftover from dinner and he perked back up to his usual self crying for food. Still wasn't time for breakfast yet though so we walked a couple laps inside my small apartment with treats to get him to exercise since he doesn't play anymore.
Tested 336 bg, ate a little over 1 can FF, got his 1 unit lantus. So far so good!

 

Small victories add up to big ones!

 

Attaboy, Kitty Cat! Eat your fudz for your mama.





Really glad that you caught the ketones and Kitty Cat was able to come home last night, and also that he's eating well today. I hope that you, too, are feeling a good deal better today, Christina.




Mogs
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I am feeling a lot better today, thank you!! Since he didn't wake me up this morning, I got fairly decent sleep for the first time in a long time. He's sleeping now which is usual after mealtime.

Question about dental health:
I'm looking at the hospital's physical exam and it states "mild periodontal disease". When he first got checked at the primary vet, she said it was pretty bad gingivitis and that he would need a cleaning but to wait until he was stronger and able to handle anesthesia so I asked about what I can do in the meantime. She suggested more prescription methods, but do you guys have any recommendations on this? I got the greenies but don't know if they really do anything other than make him happy for a quick second.

 

Hi Christina,

I suggest that you start a new thread asking for dental health suggestions and copy/paste your question above into the first post. It will help members to see that you need help with that specific topic and hopefully get you some helpful replies.

I'm glad to hear that you slept well. You've been through a lot.

(((Christina)))


Mogs
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Will do, thanks!

 

Very nice AM+6 today! (((Kitty Cat)))


Mogs
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I KNOW!!!! I AM SHOCKED!!!! My head was spinning thinking "Is this good?? Is something wrong?? Is he actually doing better?!?" He was 452 at the yet yesterday but I'm telling myself it was just stress.

 

AHHHH HELP HIS BG IS 56!!! WHAT DO I DO?!?

 

I just tested again a minute later to double check and it's 106?? What's going on! He's supposed to get insulin in 6 minutes. He seems to be starving so I'm feeding him now. I don't know which reading to believe?!

 

Hi Christina,

Can you do another test straight away and post the result as soon as you get it please.

The third test should hopefully tell us which of those is valid.

Please be as quick as you can because if it's the lower then you'll need to steer Kitty Cat in a minute.


Mogs
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It's 121 now but he just devoured a whole can insanely fast (Third test was after he finished it). does food affect bg that quickly?

 

The 56 could have been a wonky strip.
Did Kitty Cat eat during the two hours before the 56 test?

 

Thanks for posting quickly, Christina.

Questions:

1. Did you get the 56 before K.C. started eating?

2. Did you also get the 106 before eating?

3. How long after he started eating did you get the 121?

Please be as precise as you can on the timings.

 

Also:

4. What food did Kitty Cat just eat? (Either the brand and variety of food or whether it's low carb will do.)

.

 

I gave him a couple treats an hour ago while walking around since he seemed really hungry.
56 before he took a bite
106 was 2 minutes later after he started eating. i couldnt get him to stay still so i thought putting the food out would make him still enough to test again but i was having a hard time getting a good blood sample. wasted 2 more strips before I got the third sample
121 ~10 minutes after he started eating

 

FF classic chicken pate

 

That's great, Christina.

.

 

The treats were Greenies?
There is only one type of greenies that is low enough in carbs (if my memory serves me correctly) and that is the Duck and Green Pea for dogs (which may have been discontinued).

 

How long can you delay shooting without getting completely off schedule?

Edit: and do you have plenty of strips, karo/honey, high carb food?

 

Yes, a mix of greenies and purebites chicken breast. the greenies are the oven roasted chicken flavor. I guess I will stop giving him these now.

 

You did really, really well with the testing, Christina.

Kitty Cat is in safe numbers at the moment.

More questions:

* How long till his next insulin dose is due?

* Will you be able to monitor him overnight, potentially for the full 12 hours of this upcoming cycle?

* Do you have any higher carb wet food in the house (e.g. Fancy Feast Gravy Lovers)?

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I just gave him 1 unit insulin just now, 10 mins after usual time. After this weekends scare, I'm so scared of missing it and he did eat. so next dose is in 12 hours.

I will do my best! It's past 9pm here right now but I will stay up.

I have the hills w/d still, will that work?