Please help-bring to ER?

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Emily

Emily

Member Since 2014
Hi there,

I posted a few days ago asking for help with Prince's higher BG numbers. Tonight it just registered that I should be testing for ketones (I know, I am so, so, so stupid for not doing this earlier). His strip tested for small-moderate ketones. HOWEVER, after I had tested him I noticed that the strips had been opened on 2/25 of this year, and it says to discard strips after 2 mos. I have a new bottle that I will test with as soon as he goes to the bathroom next.

His breath smells normal (not like ammonia or fruit), he is alert, and he is eating fine. The only change I have noticed is that I can feel his spine a lot more, despite him not having lost any weight (I weigh him monthly). I'm guessing now that is is muscle mass he is losing, although not sure why is weight hasn't gone down. It is a very noticeable-his spine is quite prominent under his fur.

He has an appointment at the veterinary hospital this Monday. Based on the ketones, should I bring him in tomorrow morning as an emergency, or is it ok to wait??? I know things can turn quickly. Please help! I am so overwhelmed and furious with myself for not testing earlier.

Thank you!!
 
You could try an old strip on yourself. If it registers like with Prince, then wait to test him with the new strips. If it's normal, keep the ER option open.
Liz
 
He is eating and acting normally otherwise, but I read that the presence of ketones should be considered an emergency. Should I post on the regular FDMB board?
 
You could try an old strip on yourself. If it registers like with Prince, then wait to test him with the new strips. If it's normal, keep the ER option open.
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I'm a bit embarrassed to admit it, but I did try an old strip on myself and it was normal, so I'm pretty sure there are ketones in Prince's urine.
 
if more than a "trace", it's an emergency and should be checked out

Did you test on a fresh urine sample? (His, not yours :)

With the ketone strips, it's really important that they're used correctly to get a true reading
 
I went and found good advice about ketones from a recent post. ( Sabrina)



How are you measuring ketones? Basically, trace levels of ketones can be handled at home. If ketones exceed a trace level you need to contact your vet immediately. Even with low numbers, it's possible for ketones to appear.

Ketones are the result of food not being metabolized which is what happens when insulin isn't helping glucose get into the cells or there's not enough insulin available to do the job. Instead of protein being broken down, fats are being metabolized. Once they appear, the electrolytes can quickly get out of balance which can cause a life threatening situation. Ketone bodies are a by-produce of that metabolism. Ketones can appear if there's not enough insulin, a cat's not eating, and there's an infection present.

Julie is correct in that you need to make sure that Sabrina is getting insulin. Even if you have to feed higher carbs, you want to make sure that Sabrina is getting insulin since that's one of the ingredients that will help keeping ketones at bay. I've been known to tell people (only somewhat in jest) that I don't care if you have to feed your kitty a hot fudge sundae, if that's what you're cat will eat and it will allow you to get insulin in, that's what you do. (Just please don't feed your kitty chocolate -- save that for you!) Food and insulin are hugely important. Giving fluids helps to "dilute" the ketones. So, either administering fluids or adding water to Sabrina's food will help.

There really isn't a protocol for handling DKA. As I keep harping, food, insulin and water are good. Making sure you test for ketones whenever it's feasible until you're sure that Sabrina is back to herself is also important. If you see that she's lethargic, not behaving like herself, if you smell an acetone-like (nail polish remover) odor on her breath, she's staggering, test her BG and test for ketones -- especially is you notice an acetone-like smell or lethargy. Keep in mind that if you're urine testing for ketones, those levels are not as up-to-the-minute as compared to testing for ketones in the blood.
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Yes, I tried them on me and they were normal. There was definitely more than a trace. Do you think it is okay if I wait until the morning to bring him?
 
I've never had a cat with ketones but anyone who has always says it's horrible. The sooner he gets treatment the better. Give him lots of fluids.
Liz
 
Can I wait until the morning?? If I bring him tonight, I will need to leave him there, which I hate to do.
 
Sorry to hear that your kitty is testing for ketones!! I have never been in that situation, but if it were me, I would bring him to the ER tonight.

This is from http://www.felinediabetes.com/ketones.htm

Should you care about ketones?

YES! If they build up, they can lead to very serious energy problems in the body, resulting in diabetic ketoacidosis, a true medical emergency. If the condition is not reversed and other systemic stresses are present, ketones may continue to rise and a condition known as diabetic ketoacidosis (DKA) may occur. This condition can progress very quickly and cause severe illness. It is potentially fatal even when treated. Recognition of DKA and rapid treatment by your veterinarian can save your cat's life.
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You may not need to leave Prince at the ER. They will test for blood ketones (not urinary ketones). The blood test will tell you in real time if there are ketones. When you test urine, the levels are hours old -- it takes time for wastes to collect and be excreted. The danger with waiting is that the levels could be higher than what you're seeing with a urine test. On the other hand, the levels could have come down. If you bring him in, just insist that they test immediately so you'll know. They may simply test and give him some fluids.
 
Thank you so much. That was very helpful. As soon as my husband comes home with the car, I am going to bring him to the ER. So ask them to test for blood ketones? Anything else? It's odd because he has no other symptoms, but I just have that feeling, esp. with feeling his spine so prominent. I'm worried he is dehydrated, even though I have been adding water to his food and his nose is still wet.

Is this a horrible situation? Can they fix this? Managing his health has been so hard and expensive.

Thank you!!
 
We went thru ketones in early May. I second Sienne's advice....he needs blood ketone test AND he needs fluids. They can do subQ's within half an hour or so. That extra fluid will help flush things out. Sounds like he's dehydrated too so fluids will help that also. Yes it's scary but breathe...and breathe again...

HUGS and prayers!
 
Good luck!! I second the advice to breathe. Bringing him in tonight is the best thing you can do to make sure everything will be okay. I see that you're in Boston. I lived out there for a while and know that ER clinic well!
 
Is this a horrible situation? Can they fix this? Managing his health has been so hard and expensive.
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Right now it is not as horrible as it could be. There are "ketones" and then there is a condition called "diabetic ketoacidosis" (DKA).
DKA would fit into the "horrible" category, but that isn't necessarily fatal if caught early and treatedMany kitties here are "DKA survivors".

Yes, they can "fix this", but you did the correct thing in bringing him to the ER. They are well equipped to do what is needed to flush the ketones, give fluids, and adjust his electrolytes if needed. Please keep us posted, and sending good thoughts and prayers your way.

Carl
 
Sending healing vines and prayers for Prince I hope all went/is going well at the vet. We're all pulling for you and waiting for an update with bated breath.

Hugs. :YMHUG:
 
Re: Please help-bring to ER? Update

This is so hard to write. We brought Prince to the hospital last night. He has ketones in his urine, but it is only part of a larger issue. He has fat in his blood, some muscle loss, and the vet suspects he has pancreatitis or some other underlying illness. He was so upset when we brought him-I know he remembers the last visit-and had to be given oxygen and sedated. The vet wanted to do an ultrasound, bloodwork, urine cultures, and keep him overnight for at least a night, possibly more. She also said that if we can treat this, there is likely to be something else that comes up in the near future. The vet strongly recommended that we keep him in the hospital, but based on how upset Prince was, and considering his quality of life, we brought him home. We did the cultures and have pain medicine and antibiotics for him. I am going to treat him at home, and when the time comes, have a vet euthanize him here. I can't stand to see how upset he gets in the car and at the vet. I feel so horrible, guilty, confused, but my Prince is a happy-go-lucky sweet boy that I just can't bear to keep dragging to the vet and hospital. I want his time here to be comfortable and with the people that love him the most. There is a very good chance that even if they can treat him this time, it will be something else in a very short time, and I really feel like that is not a good life for him. I am going to be home with him this week, giving him his favorite foods and letting him play in the garden. This is the hardest thing I have had to do, and I feel terrible and hoping I am doing the right thing, but it is what my gut is telling me. I can't stop crying, Prince is my baby, but I want to do right for him. There is a chance he will be okay at home, but we just don't know. It also doesn't seem right to just keep bringing to the hospital-his least favorite place in the world, besides the car-for something we don't know if we can treat, and if so, for how long. I know people may disagree with this and think I should do whatever it takes to treat him, but I feel like it will keep happening over and over, and I don't want that to be how Prince lives out the rest of his life.
 
{{{Emily}}}

Please don't give up. Many cats survive pancreatitis and it can usually be dealt with fine at home....just like you're doing. I've been lucky so far and I haven't had to deal with it, but there are LOTS of people on this board who've got cats that have chronic or acute pancreatitis.

Pain control, food and antibiotics are the keys, as well as possibly extra fluids...all of this you can do at home.

Hopefully some of the people with the most experience will be along later in the day, but please don't give up on your sweet Prince just yet! Cats can live long lives after a bout of pancreatitis

The important thing right now is to control the ketones, and treat the pancreatitis.....did they give him some fluids at the ER last night to flush the ketones?
 
Do you know how to give sub=q fluids at home? It is easy to do with just a little practice. If you don't know how to do it, call your vet and ask her to give you a demonstration. I have done this many times with various cats over the years - mostly for kidney disease. It sounds intimidating but it really isn't hard.

I agree with the others. Don't give up on Prince. I have had several cats with serious health problems (heart, kidneys, cancer) who lived far longer than the vets predicted.

BTW, I think you did the right thing in bringing him home. I have a cat who HATES being in the car. His maximum toleration for a trip in a car is 4.5 miles. After that, he poops, pees, throws up, and pants. He was diagnosed with a very rare cancer (parathyroid carcinoma) almost two years ago and the recommended treatment was radiation followed by chemotherapy. Unfortunately the radiation could only be done at a location that is a one hour drive from my house. I opted not to do the radiation, but I did do the chemo since that was only a 4 mile drive. So far (knock on wood) he is doing fine.
 
I'm very sorry Emily, and I so totally know how you feel. This past April, my Trix, who had been diabetic for over 3 years but never had p-titis before, was diagnosed with Stage 4 kidney disease, high BP, and a very severe case of pancreatitis - all within about 3 weeks. It was awful and terrifying...but she is still here today, and she is doing REALLY well!

There is no way to predict if anything will re-occur or not. Take this one day at a time.

Even though Trix's case was quite bad, I still feel fairly inexperienced with p-titis, but I can say this much: pain meds, food, anti-nausea meds, and subQ fluids are very key in the treatment. Initially, Trix was on bupe 3 times a day, cerenia (anti-nausea meds) once daily, Pepcid twice daily, and 150mls subq fluids once a day. You have to make sure Prince eats, as not having enough food will bring on other issues. The meds will help Prince want to eat, because his symptoms will be relieved, but you may have to assist him a bit at first, too. (Some people also use an appy stimulant, cypro, but Trix had a bad reaction to it). And, we treated her completely at home...no staying at the vet. Eventually we were able to reduce her meds, although she still gets some because of her kidney issues and NOT because of the p-titis.

It took a lot of time and dedication, there were many happy ups and scary downs, but it was worth the effort. It took Trix several months to really recover from her p-titis, and to this day I still have to hold the plate for her to eat - but she DOES want to eat, and she IS healthy and over the p-titis.

Marje has written a wonderful primer on pancreatitis...unfortunately I don't have the link close at hand, but I'm sure someone will come along with that shortly.

Sending prayers....
 
I just want to clarify that I am not giving up. It just doesn't seem like it looks good. Due to the fact that car rides and vet visits are extremely traumatic to him (like someone else said, he pees, poops, pants, and gets frantic), I just can't bear to keep bringing him there. It is at least a 30 min drive, without traffic, and he is miserable the entire ride there and once he gets there. The hospital is just really big on having you bring him in, doing rechecks, and not very willing to work with me if I opt not to admit him. It seems like he is had a really rough time from the beginning, and treating this as aggressively as we did the first time seems unfair to him and just prolonging the inevitable. I just want him to be happy, and frequent vet checks really seems to contribute to poor quality of life.

This has been so hard and I am absolutely miserable. I can't do anything but think about Prince. I just strongly feel somewhere in my heart that bringing him back to the hospital is not the right thing to do.

I had asked about fluids and she didn't think it was necessary. He also may not have pancreatitis, it could be something else. Like I said, he has not lost weight but quite a bit of muscle mass, and has fat in his blood. We will continue monitoring, giving insulin, pain meds, antibiotics, and pepcid. I'll keep pushing to see if I can do more from home. The last time this happened it was very scary and I just don't know that we should do it all again. He is almost 10, and gauging by the issues he has had, I don't know how much time we have even if I do everything in my power to heal him. I have no idea what his history is, as we only adopted him several years ago.

This is not altering my decision in any way, but the cost is also astronomical. So far we have already spent at least $4,000, which is a lot. Everything is adding up very quickly.

I would do anything for my cat, but his happiness is important to me and I don't want to prolong suffering and miserable car rides to the vet for only my benefit of having him here a little longer.
 
Emily, sweetheart, don't give up hope.

Prince may well recover from this and have many happy days ahead. None of us can predict the outcome.

But I do so understand your not wanting to keep taking him to the vet etc. This has to be decided on a case by case basis according to what the kitty will tolerate. As an example, I had two cancer kitties that I was caring for last year, one of whom was absolutely fine with vet visits, and so we took him for seemingly endless tests, treatments - and two operations. The other kitty hated vet visits and we opted for basic palliative care. Only you know what is right for your kitty.

When a beloved kitty is feeling bad it is so easy to think that there is no hope. But many of us here have seen what a difference a day can make, or two days, or a week...

Breathe deeply. Take each day as it comes. And be prepared for any outcome; even if it is unexpectedly good! ;-)

Sending prayers for Prince's good health, and a huge (((HUG))) for you,

Eliz x
 
Any recommendations on getting the vet to work with me from home? Last night I opted to do only urine cultures and no blood cultures, because my understanding is the the blood work would only reveal things that would require him to come in again (like for an ultrasound), which I just really don't think I want to do. It's so hard. I don't want to let him go, but I cant keep torturing him by bringing him in for all sorts of procedures. It really takes a toll on him. Where do I draw the line? Should I call and just ask for fluids, or an appetite stimulant? Also, the vet basically told me that she would not do pain meds for more than three days. She said it was something she would not do long term, and that if he doesn't get better, I should consider euthanasia. I am just sick over this. I feel so guilty and torn, but seeing him like that last night was just horrible. His anxiety and fear only seems to get worse as the vet visits increase. Last night was the first time he needed oxygen because he was panting so hard.
 
Emily, I have lots of experience with pancreatitis. I wish the vet had run the blood test for it which is called the fPL. One had a couple of severe bouts and did need IV fluids but she already had lymphoma and kidney disease at the time. My now diabetic cat Max has chronic pancreatitis that surfaced when my other was so sick. He did not lose weight but had gained weight. He was on nausea medication, cerenia and ondansetron and an appetite stimulant as needed. You treat the symptoms and they feel so much better. Sub-q fluids help many cats even if they aren't dehydrated but just aren't eating enough. When Max stopped eating I gave him ondnasetron, an appetite stimulant and sub-q fluids at home because it was Christmas and I didn't want to take him to the ER. I was still fresh off the loss of my lymphoma kitty. He was diagnosed right after the holiday and never had to be hospitalized. I know how scared and sad you are right now. Until you know what the problem is you don't know if it is as serious as you think. Do you have a regular vet that you trust? If so, call today and see what he/she says?

THE ONE CRITICAL MISSING PIECE THAT YOU WEREN'T GIVEN IS NAUSEA MEDICATION. Ondansetron is a human drug. You need a prescription and can get it at Costco or Target. Cerenia is a pet medication that your vet likely carries but you can get it with a prescription at Costco also and you don't have to be a member to use their pharmacy. Don't give up hope.
 
I agree that Prince's quality of life is most important. And that includes not going to the vet. There are things you can do at home to make him feel more comfortable. One of those is fluids. It's scary at first but doable. Marje's video on YouTube is fantastic. Here is the link: https://m.youtube.com/watch?v=TtSzMuDgx78. I was just looking at it (for about the 10th) time because I'm going to give fluids to Zener and needed a refresher. It's amazing how much better Z feels with about 100 ml of fluids. I hope your vet with work with you.
Liz
 
Emily, I am so sorry you are going through this and hope and pray that Prince will rally and recover. As others have said, pancreatitis is manageable. Rusty has flare-ups from time to time and we make sure that he eats, is hydrated, and not in pain. Please read Marje's primer on pancreatitis (the link is in Chris's post, above).
Marje also made a terrific video about how to give subcutaneous fluids. It takes you step-by-step through the process. Here's the link: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=75933
It is very important for a kitty to be well hydrated if ketones are present. They have to be flushed out.I don't understand why your vet is reluctant to recommend that you give fluids.

We are all supporting you in whatever you decide to do. Cats are very strong. They don't give up easily.

Sending him many many healing vines,

And hugs for you, :YMHUG: :YMHUG: :YMHUG:

Ella & Rusty

p.s. I see that Liz has sent you the link to Marje's video, too. Do watch it!
 
pancreatitis is very common in our diabetic cats. very common. punkin had one bout of acute pancreatitis, and chronic pancreatitis ongoing for some time. he was sick for a few days and then back to himself.

take a peek at the links you've been given on pancreatitis. people do all the treatment at home - sub q fluids, pain relievers, etc. this is definitely NOT a death sentence. it's common for cats to get sick and feel crappy for a few days and recover back to their usual selves.

hang in there - one day at a time. i would absolutely not give up hope on him. it shouldn't cost a fortune to treat this.

i can't believe in Boston there isn't a mobile vet who would come to your home and get you started with subq fluids and the right things to help Prince get back on his feet. 10 years is young. you could have another 10 years with him.

big hugs as you figure out what to do next. :YMHUG:
 
Emily, I'm so sorry to hear about Prince. As the others have said there is a lot you can do for Prince at home. I think it would have been good to get the blood work done since you were already there, that way you would know if it is pancreatitis. They couldn't make you come back for more treatments you know. Remember, the vet works for you and you are Prince's advocate. If your vet doesn't want to help you w/ home treatment, is there a vet closer to home that you could try? Most offices will do an interview to see if you wish to become a client for no charge.

Is Prince eating? Food is a very important part of treating pancreatitis. If they didn't give you any nausea meds and Prince doesn't want to eat you can give him 1/4th of a Pepcid (just the plain Pepcid) or you can use a syrup of Slippery Elm Bark:
Take a glass container which holds two cups. Put one cup of water in the cup. Add 1 to 1.5 tsp of slippery elm bark powder.

Heat in the microwave on high for about 1.5 minutes. Remove from the microwave and stir, then put it back in for about another 30 seconds. Keep an eye on it because you do not want it to boil over. Remove from the microwave and stir again.

Allow to cool and give ¼ - ½ (0.25 to 0.5) teaspoon up to 4 times a day. This will keep at room temperature for a day or in the fridge for up to five days.
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. You can find it at most health food stores in the bulk herb section. It coats the stomach to prevent excess acid from making them nauseous and it is very gentle.
 
Emily,

I have been following this on the main forum, so I'm replying even though I don't normally post here. Forgive me!

I am so sorry that you are going through this. I thought I would post our story in the hope that it would give you some encouragement. Tisha had an emergency visit to the vet in June with very similar symptoms before her diagnosis with diabetes. She had vomited before I left that morning, but that wasn't really uncommon for her and we were already trying to figure out if there was a bladder/kidney issue. When I got home, she was lethargic and my daughter told me she had been vomiting all day and was just lying in the corner whimpering. She hates the car, hates the vet, and hates other kitties. Normally, she starts yowling about halfway to the vet and I have to fight her into the carrier. I didn't have any trouble getting her in the carrier and she just silent the whole way there. I don't know about ketones, but I know there was enough fat in her blood that they couldn't even get valid results because the fat kept clogging the machine they use to run the labs. She was diagnosed with pancreatitis and sent home with antibiotics and pain meds. We also hate to leave her at the vet because she is so miserable while she is there. She promptly found a quiet spot at the end of the hallway and I swear that she barely moved from there for about 3 days. We moved her litterbox, food and water close, but she was not eating much. We kept giving antibiotics and pain meds and I constantly worried. It sounds like that's about where you are right now. Okay, so that was the bad part. Here's the good part: After several days, she did slowly start to perk up. Her appetite returned and she started moving more. She seems to have completely healed from the pancreatitis. Now her only symptoms are related to the diabetes, and they are fairly mild. (Diabetes and pancreatitis are closely related. Basically, the vet told me that she's probably diabetic now because her pancreas was injured by the pancreatitis and is not producing insulin like it should.)

So that was all a long way of saying that while things may look discouraging now, they will probably get better. Like I keep seeing on the diabetes posts, you have to be patient and recognize that it can be a long road. I hope that Prince feels better quickly and that you can start feeling better about things. I absolutely agree with your decision to bring him home. He wouldn't feel better if he was at the vet's office and completely stressed out about being there.
 
(((Emily)))

I just wanted to send Prince many healing vines and prayers and some hugs for you. One of our most experienced member's kitty, Alex, also has a very difficult time at the vet and her mama has learned the symptoms and signs of what might be developing and treated her successfully at home for pancreatitis and possibly some other issues like triaditis. These were not specifically diagnosed because Alex hates the vet.

The one thing you must stay on top of is the ketones and you absolutely should be giving him subq fluids because that will help the ketones. But it is important to also be sure he is eating, his insulin dose is appropriate, and he has no infection. Did the vet check his mouth or does he have any symptoms of a UTI?

The value of bloodwork is to identify if he has any condition that is treatable at home. Just because the bloodwork might reveal something that the vet thinks needs an ultrasound does not mean you have to do one. But there are am y things the bloodwork can tell you that you can address at home.

How about a mobile vet? You live in Boston and I would think there would be very many that could come and perform many routine tests. I would strongly urge you to try that so you can at least have some labs to see what's going on and what you can and want to treat.
 
I know you haven't given up on Prince, Emily, but it sure sounds like this vet has....cutting a cat off of pain meds after 3 days and suggesting euthanasia is the only answer is just absurd. Many cats, like many humans, need maintenance pain meds for a wide vareity of reasons, and they certainly deserve more than 3 days to recover from any sort of illness. I keep Trix on maintenance doses of her Pepcid, fluids, and cerenia because they make her feel well and happy and comfortable all the time. It's a small effort for us to do that for our beloved pets, and it's a shame that this vet doesn't think that way.

I think a mobile vet is a wonderful idea for Prince, and you do need one who will work with you and Prince as an individual, unique kitty. He still may not be super-thrilled, but at least you would be able to avoid the car ride.

We're here with you.....
 
I also agree with Amy. Our Gussie was on buprenorphine for over three years at a maintenance dose for chronic arthritis. I'd be tempted to ask the vet if she went to the doctor with pain and the doctor limited her to three days, how would she feel?
 
Emily, I've been reading along here and I'm so sorry that you and Prince are going through this!

I also wanted to recommend finding a different vet as the solution to the resistance to care in the way Prince needs it. Frankly, it seems fairly cruel on your vet's part not to work with you.

I'd suggest calling Angell Memorial (the ASPCA clinic in JP) and asking them if it would be possible for you to purchase fluids and needles from them and to come in for a lesson on how to give them (without the cat!). We were sent home with sub-q fluids for a ferret who was given a poor prognosis that we chose to take home. It probably depends largely on the individual vet, but ours didn't have any hesitation in giving us all the materials we needed to keep him comfortable at home for the remainder of his life.
 
Agree with so many others here. Though I'm fairly new to this and haven't dealt with some of these things... we were diagnosed by a vet that sounds a lot like yours. Wanted to do everything at the vet, insisted on keeping him there (for 11 days, as he continued to decline due to them not giving him the care I was paying for), were against any treatment or even TESTING at home...

With the knowledge I found here and the support of these guys, I took him home - to live or die. He was miserable there and I knew he'd never "stabilize" enough to come home in their eyes. He was too stressed out to get better. This is a cat that most of my friends didn't even know existed because he becomes invisible around anyone but us.

He's still around, and though we're not having the greatest time at the moment, he is doing ok. He is HAPPY. He's 11 - so like your guy, not THAT old. I dont know how long we'll have him... but I'm SO glad I did NOT listen to the vet. The day they diagnosed him with diabetes (and DKA) the vet told me that IF he survived the DKA, it would cost thousands and would be expensive for the rest of his life. He strongly suggested euthanasia. Well, it DID cost me thousands... but mostly because I didn't insist on taking him home sooner. I should have done that as soon as the DKA was on the mend. They wanted his BGs stable before sending him home - as IF that would happen at the vets office (plus they weren't checking him regularly and let him stay hi for 12 hours, setting him back several days). He was OTJ after just a few weeks at home.

Anyway... my point is... 1) there's a very good chance you can do this, and 2) FIND a vet that is supportive! A mobile vet sounds like a great idea in your case - I wish we had them here. My vet makes farm calls, so I probably COULD get him to come out for Tink if I had to... but luckily it's only about 5mi away so we have just driven there so far. Unfortunately, there are vets out there that want to hospitalize a cat for ANYTHING. My old vet wanted me to leave my other cat there so they could get urine from him, because "he had an empty bladder" and they couldn't get any out via the laser guided needle. WHY they didn't just do a catheter like a different clinic had done previously I dont know. And his bladder was NOT empty, as he peed all over me 5min later in the car. I was SO mad at that vet. And so glad I refused to leave him there. Just like human doctors, some are great... some are not-so-great. Find one you trust.

On the other hand, as someone with a 10yr old pug and two 11yr old cats (plus last year we lost our 14+yr old pug, our 12yr old cattle dog and our 17yr old cat) - I am a strong believer in quality of life. When the quality is gone, I make that excruciatingly hard decision. Tearing up just thinking about it... but it's our duty. But ONLY once quality of life is gone. Until then... enjoy the time you have and do what you can to maintain that quality.
 
Prince Update 8/11

Thank you so much, everyone, for all the support and suggestions. I thought I would feel really judged for bringing him home from the hospital but it sounds like people really understand and are quite sympathetic. I so much appreciate the support because I feel that bringing him anywhere is just too traumatic. I think that the vet last night really convinced me that the situation was stay in the hospital and get better or go home and die, but he was so fearful and upset I just could not bear to leave him.

So here is where we are now:
-The vet that said they would not prescribe pain meds or fluids at home was the vet on-call at the hospital. Based on what people said here, I called our primary vet and he gave us fluids. He also changed the antibiotic to Orbax (it was Clavamox and he said that he didn't like that because it could suppress appetite). Prince also has his pain meds, and I am pretty sure it would not be a problem to get more from our primary vet. After everyone pointed it out on here, it now seems ridiculous that the on-call vet said she would not prescribe them longer-term. Prince also has peptid to take.

He is eating a bit (less than before), but at least he is eating. He seems more alert and is purring this afternoon, too. I think he is starting to decompress after last night. We didn't get home until about 3:30am. I really appreciate all the videos and links that were sent to me about giving fluids because we are going to do that tonight.

The only other thing is that last night at the hospital, I declined having his blood tested, because the vet pretty much implied that there wouldn't be much we could do at home based on the results (they had drawn blood from him upon arrival). I called back today to ask if they still had his blood and could test it, but they don't know and will call back. We will get his urine results and culture in a few days. I'm not sure what to do if they don't have the blood anymore.

I will look into the home vet. I didn't know that those existed, but it is really good to know because I think I am done bringing Prince anywhere. I have never seen him so upset. Typically he is a very laid-back, social, and happy cat. I have only had him for a few years-I adopted him from the shelter and have no idea what he has been through in his past, and I want him to be happy, comfortable, and feel safe here.

Thank you, thank you, thank you. The prayers and good thoughts are greatly appreciated (as is all the advice and compassion)!
 
{{{Emily}}}

I'm so sorry you and Prince are going through this. I agree with all the others that say you did right to bring him home. I also agree you should look for a mobile vet that will work with you. Boston is a big city, so there must be one out there. Please look.

I, too, had a vet that wanted to do the treating at the clinic, and encouraged us to euthanize Cinco when he didn't get better. We almost took that step, but Cinco told us he wasn't ready. That was three years ago, and he's asleep on the family room floor right now. :-D I only take him to his regular vet for vaccinations now. He has lymphoma and is blind, so he does see an oncologist and an ophthalmologist. We chose not to treat the lymphoma, and he's cancer free since his tumor was removed (knock on wood). Chemo would have destroyed the QOL we had worked so hard to give him. My point is that the vet doesn't always know best. You know your cat. There is so much you can do at home for him, so keep going and lean on the people here for support and guidance. We're here to help and we are all pulling for you and Prince.

BTW, if I can give sub-q fluids, anyone can!!! Marje's video is an absolute must watch.

Many healing vines and lots of hugs. :YMHUG: :YMHUG: :YMHUG:
 
Hi Emily, as far as feeding Prince, have you tried giving him Stage 1, chicken or turkey baby food? It has no cornstarch in it, and cats do not digest the cornstarch very well. Stage 1 baby food is the EASIEST food for a cat to digest. However, it does not have a lot of calories in it, so you would not want to try to feed this for every meal. If I were you, I would feed it to Prince at least once or twice a day, at his morning and evening meal, when he is the most hungry.

When he has pancreatitis, you MUST keep him eating, or else you might be dealing with a deadly disease from a lack of food which is fatty liver disease.

http://cats.about.com/cs/healthissues/a/fatty_liver.htm

It is AWESOME that your regular vet prescribed the sub-qs for Prince, have you administered any of them to him yet? It is very important that he get them. If Prince is any what dehydrated, he will not eat. Dehydration makes both humans and cats nauseous. The sooner you can get the fluids into Prince, the better.

The pain medication, (I hope that it is Buprenor?), will also help him tremendously. If the vet did not instruct you on how to administer this to Prince, you must apply it to Prince's gums and not squirt it down his throat, nor mix it into his food. His body's response to the pain medication, when applied correctly, will be almost immediate.

What did they say about the ketones, anyway? When a cat is treated for ketones in the hospital they are ALWAYS put on an IV drip to clear the toxins from his blood stream. Ketones means toxins in his blood. This is another reason why it is imperative that you give Prince his sub-q's every-single-day. Because you declined doing that at the hospital for him, he must have the fluids at home. Sub-qs are not as effective as an IV drip,

I know this is very scary for you and that you are extremely worried about Prince, but you need to stay strong for him to be able to give him the at home medical attention and care that you plan on doing. I am sending you the healing white light of the Medicine Buddha, so that you make wise and calm choices for helping Prince through this bout of illness.
 
Ask for cerenia or ondansetron for nausea.It is the missing piece from an otherwise good perfect list of support. Pepcid is only for stomach acid and won't help with nausea from pancreatitis. Is the pain medication buprenex? You just need a tiny amount on the gums for it to work so no need for pills or syringing liquids.
 
For years, I used a vet that made housecalls. Gabby is not a happy kitty when it comes to car rides. It's a great option. I do know a few people in Boston so if the options that were provided don't work out, let me know. I can check with friends about a vet who comes to you.

Pancreatitis is very treatable. The think to keep an eye on are the ketones. Fluids, food, and an antibiotic if the cause is an infection are key as is enough insulin.
 
I just wanted to pile on a garden of vines for sweet Prince. Cats are amazing lil creatures - don't give up and stay strong!
 
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