Newly diagnosed and hardly eating/syringe feeding

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autofade248

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Edit 04/18: Billy passed away.

Hi everyone,

I've been lurking since my cat (Billy, 15yo male) was diagnosed about 2 weeks ago. I finally joined because we started insulin yesterday.

General background info: about three weeks ago, I thought Billy had less energy than usual, mostly slept, etc. Took him to the vet, had bloodwork done and got the diabetes diagnosis. However, we didn't start the insulin right away because he was hardly eating. I immediately started feeding (at least, try to) him low carb canned food. He would usually smell the food, lick here and there and walk away. We tried an appetite stimulant, but things didn't change. I fed him by hand a few times to get some food in him. We also have another cat (Timothy, 14yo male) that eats anything so it's pretty much impossible to leave food out and hope that Billy will touch it because Tim will eventually take it all. Billy didn't get better so I thought he might've DKA, pancreatitis, etc. but after another visit at the vet, they said he had nothing else. We had to start syringe feeding him (about a 5.5oz can/day) and he also showed signs of neuropathy so I bought methyl B12 supplements. So, finally, we had an appointment yesterday evening for insulin demonstration.

Vet gave him 2u of caninsulin and I told her I wasn't comfortable with that choice, would rather use Lantus. His BG was 576 at the time. After our appointment, we bought our home testing kit (vet was selling iPet but I bought Accu-Chek Aviva) and I also decided to buy Lantus. I tested him 4 hours later, his BG was 265. So far home testing is going great, AMPS was 238 and +4 was 225 (after first shot of Lantus). We're still syringe feeding him and we're trying to give him more (1.5 can would be my goal).

Our main concern right now is hoping that he will get his appetite and energy back. Yesterday, the vet said that his state was worrying and hospitalisation (24/7 monitoring) could be the next step to get him back on track. Financially, I'm not sure if I can handle that. I decided to at least start the insulin and see how things go during the week.

I'll be posting my SS soon and adding it to my signature.
 
Welcome! Good insulin choice and great job hometesting. Have you seen this website by a vet? www.catinfo.org. She has great ideas for transitioning from dry to wet. We found our civie just didn't get the texture of the pate types. Once we added wrm water and made a gravy, he liked it better. Have you tried FortiFlora? It's a probiotic made with the ingredient that makes dry food so irresistible. Doesn't work for every cat, but for some, it is magic.
 
Sue and Oliver (GA) said:
Welcome! Good insulin choice and great job hometesting. Have you seen this website by a vet? http://www.catinfo.org. She has great ideas for transitioning from dry to wet. We found our civie just didn't get the texture of the pate types. Once we added wrm water and made a gravy, he liked it better. Have you tried FortiFlora? It's a probiotic made with the ingredient that makes dry food so irresistible. Doesn't work for every cat, but for some, it is magic.
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Yes, I got a lot of useful information from catinfo (especially the food chart). We've tried some tips listed there (tuna, parmesan, warm food) but that didn't work. I'll look into Fortiflora.


BJM said:
Yahoo Assisted Feeding Group for tips and tricks and things you may need to know for assisted feeding.
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Thanks a lot for the link!
 
This "low carb canned food" wasnt Purina DM wet was it? Lots of cats eat that once or twice then wont touch it again.. they get sick of it real quick. You might want to try fancy feast pates or Friskies pates or the Wellness with the grain free label on it.

Good job on the spreadsheet and insulin choice and home testing!

let us know on the food.

Wendy
 
How did your vet determine that your cat does not have pancreatitis? The best test for pancreatitis in a cat is the Spec fPL, which is a fasting blood test that needs to be sent away for results. A common symptom of pancreatitis is nausea. When a cat is nauseous, they will often approach the food and/or smell it and then lick their lips and walk away. Here is a link to read called A Primer On Pancreatitis. Being nauseous does not necessarily mean throwing up. If your cat is nauseous, you do not want to give her an appetite stimulant until after the nausea has been addressed.
 
Deb & Wink said:
What was he eating before you tried the switch to low-carb canned food?
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It's funny actually because before I took him to the vet the first time, I was transitioning to better dry food. I was just learning about good cat nutrition, grain free food, etc. So both cats were on Royal Canin Indoor Mature for a while and then I bought a bag of Orijen dry food. Then, a few days later, Billy seemed lethargic and visited the vet.

Wendy&Tiggy said:
This "low carb canned food" wasnt Purina DM wet was it? Lots of cats eat that once or twice then wont touch it again.. they get sick of it real quick. You might want to try fancy feast pates or Friskies pates or the Wellness with the grain free label on it.
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No, not at all! I did a lot of research on what food to get and which pet stores in the city were selling which brands. I went to about 5 stores to get a big selection of cans: Wellness, Nature's Variety Instinct, Go! Natural, Ziwipeak, Merrick, Weruva. Also got some FF cans. I would say, out of them all, he seemed to like Ziwipeak the most but that was at the beginning, when he was still semi eating by himself (in the can or in my hand).
 
Dyana said:
How did your vet determine that your cat does not have pancreatitis? The best test for pancreatitis in a cat is the Spec fPL, which is a fasting blood test that needs to be sent away for results. A common symptom of pancreatitis is nausea. When a cat is nauseous, they will often approach the food and/or smell it and then lick their lips and walk away. Here is a link to read called A Primer On Pancreatitis. Being nauseous does not necessarily mean throwing up. If your cat is nauseous, you do not want to give her an appetite stimulant until after the nausea has been addressed.
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That's a good question, I've no idea. I missed 2 vet appointments due to school so my mom went for me. I had asked her to ask about pancreatitis but I'm not sure how the vet determined it wasn't that. I'll call the vet tomorrow and ask. If there's fasting involved, that means I'll have to stop the insulin during that time?

As for nausea, I had concerns about that too. I tried pepcid ac 2 times (including once when we didn't give him the stimulant) and it didn't seem to have any effect. He has not vomited in the last 3 weeks.
 
the vet can give anti-nausea meds and appetite stimulants - even if your cat doesn't have pancreatitis, you can act as if she does and treat the same way - basically it is painful, makes the cat nauseous - not necessarily vomit, and while she wants to eat, her tummy hurts that she just can't - so i would ask the vet about using anti-nausea and appy stimulants to help her and if pancreatitis, you may want pain meds too like buprenex.

does she look at her food, lick her lips, turn her head away? all signs of nausea.....
 
Hillary & Maui said:
the vet can give anti-nausea meds and appetite stimulants - even if your cat doesn't have pancreatitis, you can act as if she does and treat the same way - basically it is painful, makes the cat nauseous - not necessarily vomit, and while she wants to eat, her tummy hurts that she just can't - so i would ask the vet about using anti-nausea and appy stimulants to help her and if pancreatitis, you may want pain meds too like buprenex.

does she look at her food, lick her lips, turn her head away? all signs of nausea.....
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Yes that's mostly what he's been doing. The first couple weeks he would look at the food, lick his lips and if I insisted and kept the food near his nose/mouth, he'd finally lean in and lick it a bit. But lately he's been really uninterested so that's why we started syringe feeding. I could try the Pepcid again. This won't affect the insulin or his BG?
 
correct - pepcid won't affect it -as this has been going on for a week - i strongly suggest you ask the vet for anti nausea meds and appy stimulants - you need to jump start her feeling better

and what you described is a cat with upset tummy, nauseous and possible pancreatitis - which it really doesn't matter if you test for it or not - you have enough symptoms you need to treat this and yes it is painful -

the same thing happened to my non-diabetic cat and it was a struggle getting her to eat - i even offered dreaded kibbbles which she LOVES and she wouldn't touch it - used pepcid, and the other meds and within a few days she felt better and started eating again

your issue is compounded because of diabetes, but you need vet intervention - they can give stronger drugs than pepcid
 
I use Ondansetron for nausea for J.D. and Pepcid, when I think he's having a flare up of pancreatitis.

I don't know why, but some vets will ask if the cat is throwing up, and if not they say the cat is not nauseous, but they don't have to throw up to feel nauseous.

Anyway, you don't want to give an appetite stimulant to a cat that feels nauseous. It would be like you having a terrible tummy ache and getting a medicine that makes you want to eat but you don't want to eat because your tummy hurts.

And vets will palpate the tummy to see if it hurts, but cats are notorious for hiding pain.

Get some anti-nausea meds, and give those and then try the appetite stimulant.

If your vet will give you some buprenex for pain, that would be great too. You want to give it per your vets instructions but only as needed. Just do not allow your vet to give Metacam for pain. Most of us have No Metacam and No Convenia written in our cat's charts.

I hope your kitty is feeling better and eating on his own soon.
 
Hi Autofade, not sure if this is a recommended procedure but maybe you could try some deli meat such as ham? My cats go absolutely nuts over any deli meat, not sure if it will help in your situation. I am actually in a very similar situation, have a cat recently diagnosed with diabetes that will not eat. I think I am going to try the deli meat idea tomorrow.
 
If the cat is nauseaus, no matter what you feed, it may provoke more digestive upset.

Also be careful with force feeding in this situation as it may create food aversion by being associated with feeling nauseaus.

Really need to get the tummy calmed down!
 
Thanks for the feedback everyone, It's very much appreciated. I will call the vet tomorrow and ask about anti-nausea meds and pancreatitis test. Are there any anti-nausea meds that should be avoided?

Edit: I will be going to sleep soon, but I wanted to post a question in case anyone could answer by the time I get up. I just tested Billy's BG (+5) at 70 which I think is amazing after only a bit more than 24 hours on insulin. However, if his AMPS is still low, I feel like not giving the shot would be a bad idea because he's only starting insulin. Could I decrease the dose by 0.5 after only a day and a half? Or should I stay at 2u at least for the first few days?
 
2 units is high to start a cat on lantus.
Most cats start on .5 or 1u - with most starting on 1u based on ideal weight.

If you are still up, I would get another test in as 70 at +5 could be a cause for concern for a cat just started on lantus.
Although nadir is generally around +6, it could be later and he could still be dropping.


We also advice newbies not to shoot if under 200 as you don't have the data to predict what will happen during the cycle, ie. how low the bg will go.

\
 
Sounds like you and I are in about the exact same boat Autofade. My cat is also not eating (but due to antibiotics for an infection), I just started her on insulin about 24 hours ago, her most recent home BG test was also in the 70's.
 
Update on my situation: Billy's BG was at 18 this morning so I did not give him insulin. However, he did eat a bit of food by himself so that's an improvement! BG was back up at 113 an hour ago. Talked to the vet, said to start at 1U if his BG goes up to around 270. As for the pancreatitis, they did not do the Spec fPL test so that could be the next step if Bg stays low but appetite/energy don't come back. They also don't have any anti-nausea meds, only anti-vomiting. I'll continue with pepcid and see how that goes.
 
You're in Montreal, Canada What is your meter reading units??

If the US page of your spreadsheet has the entered numbers; STOP ALL INSULIN NOW until we can figure out something for him.
 
Whoa there!! 18 is hypo land. Next time you see any number under 40 you want to start feeding high carb food to bring him up. I am glad he was ok and very very glad you didnt shoot but please read this primer : http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=15887

I will ask some more experienced dosing people to come and advise, however

1. The dose is too high and because he dropped that low I agree with your vet that you drop down to 1 unit tonite as your starting dose and use that for a few days to see how he does. Unless he drops under 50 again and then you reduce further.

2. Because he was so low this morning and he didnt get insulin you can expect to see some high numbers for the next few days. Do not panic. this is called a bounce and will clear itself within 72 hours. Stick to the recommended dose.

However I want more eyes on this as I am concerned that he isnt eating and even 1unit may be too much.


Wendy
 
It was 1.0 mmol/L so yeah 18 in US units. He didn't have any of the hypo symptoms I had read about so I wasn't sure if I had to give him sugar or not. Luckily I was home so I tested a few times after and the numbers were going back up. So whenever I get low numbers, I should give him honey/syrup/etc. even if he's not showing hypo signs?
 
A cat may not show symptoms until it is too late; follow this hypo protocol.

No shot tonight unless over 200, OK? You are d*mn lucky your cat isn't dead.
 
The only symptom my cat Wink showed was dilated pupils. Easy to miss especially in low light. So yes, please test if suspicious and give simple sugar. Karo syrup, honey, maple syrup, etc. all work to quickly raise the BG levels.
 
Promise I won't shoot tonight if it's not over 200! I guess I wasn't prepared to hit that low so soon and wasn't sure if I had to follow protocol or not. His case is very confusing...
 
I have never seen a BG test of 18. ..big blowing out sigh.. Only a LO which is 20 or below on most meters.
I'm glad you caught that. I think I would skip the shot tonight. Please be very careful. You do not want to see an 18 again.
 
Maybe give 0.5 units. After a hypo event, many cats are more sensitive to insulin.

If you ever get a test below 40, re-test to confirm the low numer or to identify testing problems (bad strips, etc).

The FDA allows glucometers to read + or - 20% of the lab value. If you take 2 tests at the same time and the 20% higher level of the low test is greater than the 80% lower level of the higher test, the 2 tests may be considered equal. Additionally, the lab value is likely to fall in the overlap range.
 
I gave 1U. BG at +2 was 335.

I thought I'd add some information that I omitted in my intro.
- He's at 12 pounds now, lost a lot of fat/muscle (I can feel his bones). Vet said his ideal weight would be around 14 pounds because he's a large cat.
- When we got the diabetes diagnosis, he also got treated for an UTI with an injection (Convenia). He got the second injection on Monday.
- We're trying to keep track of if and when he pees and poops. We've found some little pieces of poop here and there outside the litter box. Seems like he gets there on time if he needs to pee, but pooping is harder to control.
 
Welcome to our family. A short introduction: Gobbles is my sweet sugar-boy; he's an 11 year old, neutered gray tabby that was dumped near a local farm. My name is Kat and I live in Ohio. What's your first name? I am so glad your kitty is ok. You are doing a fantastic job! Believe me, this get's easier and you are in very good hands.
 
Thanks everyone for the warm welcome and the support so far. I'm very grateful Billy is still alive after yesterday's drop! His AMPS was 376 this morning.

I've introduced my kitty but not myself! My name's Mathilde, I'm a grad student currently still living at home with my mom. She's extremely supportive and helpful. She has a much more regular schedule than I have so I can count on her to test and shot if I can't be home. The hardest part, besides Billy's health of course, is the money. We used to spend around $30/month for food for our 2 cats. Wet food isn't so cheap around here, most 5.5oz cans are $2. And of course the test strips! It's a shame we don't have access to ReliOn in our canadian Walmarts.
 
The WalMart in Columbus carries Friskies pates in the 13 oz cans for $0.78 to $0.84 US. That size can may be large enough to feed half in the morning and half in the evening for your cats, if your WalMart carries it. Also check for farm supply companies; sometimes they have decent prices on basics.
 
Since you are Canadian here are some tips;

1. You can get a free bayer contour USB meter and 25 strips if you go to http://www.bayerdiabetes.ca/BDoffer and use code "BDS 11-14" And then if you register the meter when it arrives, you get a free USB wall charger. Its a reliable meter. This offer was in the flyer comes inside the BD ultra fine 3/10cc syringes you get in Walmart Canada. I used a similar one six months ago and it worked great so bayer seem to run it a lot. The strips are expensive in stores $75 for 100 in Shoppers for example but you can get them for half that price on eBay. But of course if you get them in shoppers you can get points! I havent found a good meter that has strips cheaper than that - they all seem to be about the same price.

2. food - I use the fancy feast pates since they are low carb and reasonably priced. I keep an eye on pet value, walmart and petsmart and usually someone has a deal and I stock up. I never pay more than 65c a can. Currently Pet Valu near me is selling them at 60c. And currently walmart.ca is selling the Friskies pates 5.5oz can for 66c free shipping

Edited to add: his pink numbers currently are what we call a bounce - a reaction to the serious low yesterday. Dont panic it will clear within 72 hours... just keep with the same dose unless he drops again under 50 and then you drop the dose. No shooting under 200. Also can i invite you over to post in the tight regulation forum where more eyes can help advise you? Many members post there daily and experienced members comment and advise on dose, answer questions etc - plus its a great sense of community! : http://felinediabetes.com/FDMB/viewforum.php?f=9

Wendy
 
Re: Convenia warning........

Hope + (((Baby)))GA said:
Please read all the info in this link that Dr. Lisa has made available on the dangers of Convenia before allowing your vet to give a 3rd shot of this drug.

http://www.catinfo.org/?link=convenia
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Thanks for the link. I actually stumbled upon it yesterday. The vet prescribed 2 shots so Billy shouldn't be getting any more.


BJM said:
The WalMart in Columbus carries Friskies pates in the 13 oz cans for $0.78 to $0.84 US. That size can may be large enough to feed half in the morning and half in the evening for your cats, if your WalMart carries it. Also check for farm supply companies; sometimes they have decent prices on basics.
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There are no Walmarts close to my house but I did see that I can order online. The 13oz cans on their website is at $1.32. Thanks for the tip.
 
Billy passed away Saturday (April 13, 2013), just 2 months shy of turning 15. It all still feels so surreal. He was the most loyal and loving cat. I will always love him and he will forever remain in my heart.

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A long time ago, he was a tiny kitty:
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Oh I am so sorry, what a beautiful kitten and cat he was. My condolences to you and your mom. Again I am so sorry you lost Billy.

Terri
 
Mathilde, my heartfelt sympathy to you and your Mom on the passing of Billy. Beautiful kitty with such a cute face. There had to have been something else going on, possibly a cancer somewhere, and diabetes was discovered and many times it is a secondary disease but the first to be noticed. You did everything you knew to do to help him. So sad and my heart goes out to you on the loss of your beloved Billy wings_cat rb_icon
 
Thanks everyone. I'm so glad to have found this community even though Billy's story ended too quickly. The love and spirit on these boards are amazing.
 
I'm so sorry ((((((((Mathilde))))))))))
Billy knew how much he is loved by you, and he loves you too.
He is waiting at The Bridge, and he will be there to happily greet you one day.

Fly Free Beautiful Billy.
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Please visit your mommy when you can.
 
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