Sick kitty, not sure what to do

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lisam

Member Since 2013
My cat, Arthur, was diagnosed with diabetes about a month ago. He was in ketoacidosis and had to be stabilized in the hospital for three days. I'm very low income, but I was able to fund it through organizations and save him.

He's been on 1 unit of Lantus daily since then and been fine. He eats classic Fancy Feast. A couple days ago, he was acting lethargic and didn't want to eat his food, which is very unusual for him (he's not a picky cat, and mealtime is usually exciting). I checked his urine and found ketones. As much as I wish I could take him to the vet again, I simply don't have the money and already exhausted my fundraising a month ago. I kept him hydrated by feeding him chicken broth with a dropper every 20 min to an hour, depending on how much he can keep down.

His blood sugar was initially 163, and it went up to 213 later. His urine stopped testing with ketones in it, but over the last day he stopped urinating so I can't test more. He's still lethargic and refusing to eat, and I'm still giving him chicken broth. He will drink water and milk. I'm new to blood testing, and I can't seem to get another drop large enough to test, but I want to be able to test before I give him another insulin shot, since I don't know if he's high or low right now.

I know I should take him to the emergency vet, but I am down to $25 in my account right now. Any advice on how I can get a decent blood sample and other things I might be able to do at home are much appreciated. I love him and want to get him through this.
 
Hi Lisa,
Just wanted to see if I could help with the blood testing.

Are you using the lancet device, or "free-handing" the lancet? I'm assuming you're trying to hit the "sweet spot" between the vein you can see on the ear, and the edge of the ear? If you can't get any that way, try hitting the vein. You don't want to do that every time, but it some cases it's necessary for cats who don't like giving up the blood. It will bleed more, so use a cotton ball or tissue, and press firmly on the poke spot after you get the sample for about 30 seconds to stop it.

If found it easier to hit the spot I was aiming for by using the lancet free-hand. It just helped me see things better.

I've asked some people from the Lantus group to come take a look at this as well.

Carl
 
Thanks Carl - I'm freehanding it but still not getting much. It may be because he's dehydrated? The emergency vet that treated him before said I can come in and they will do it no charge to see where he's at. But even then, I'll need to find a way to treat him at home. What are the best ways to handle either high or low blood sugar episodes in a cat at home? I know it's very substandard, but it's all I can do right now.
 
Please keep testing for ketones any chance you can get. I'm glad the last reading was no ketones. You can put a layer of plastic wrap on top of the litter, just in case you miss his next visit to the litter box.
Ketones really need a vet visit. The recipe for ketones is not enough insulin, not enough food, and infection.
My cat is a DKA survivor.
I often, even after 8 years, have to poke more than once and sometimes as many as 8 times :oops: in the same spoke or close to it, to get a blood sample big enough to get a test, and I use the 28 gauge lancets. You'll want to use the larger (width wise) lancets to make it easier to get a blood sample. If he's had ketones recently, he needs his insulin.. and food. Please try to be calm and keep trying to test, and give him a treat or some lovings and pettings whether the test is succussful or not, and let us know what his BG is.

Is he dehydrated? Are his gums tacky when you touch them? If you pull up on the skin at the back of his scruff, does it fall back into place quickly?

I wish you the best of luck with your kitty.
 
What are the best ways to handle either high or low blood sugar episodes in a cat at home? I know it's very substandard, but it's all I can do right now.
Click to expand...

The key is home testing. If you know when he's high and when he's low, it makes it much easier. As far as treating low numbers, here's a link on how to manage those. And any time you have questions about the numbers, of course you can post here and people will try to help you to understand and how to react.
http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=61799

If he's dehydrated, depending on how badly, there are ways to deal with that. One is to administer sub-q fluids. But you would need a vet to advise if that is appropriate for your cat. It can fix the hydration issue, but in some cases, might not be the best way to go about it. Cats with heart conditions, for instance, you would only give fluids based on vet advice. It is something, however, than can be done by you at home, and many of us have done this. If your vet advises it, we can help you out.

Carl
 
i'm actually more concerned that he's not urinating. If he's blocked, it can be a life threatening situation. I'd really encourage a trip to the vet/ER around the not peeing. Have you investigated Care Credit?
 
Our vet kindly checked him for free. It turns out the issue is not with his diabetes; he developed hepatic lipidosis. I'm syringe feeding him multiple times a day while monitoring his blood sugars closely. A feeding tube would be dangerous because his diabetes increases the risk of infection. Fingers crossed that he turns it all around. Thanks to all that gave advice, it was much appreciated and very helpful.
 
That was very nice of your vet to check Arthur for free.
I'm glad you have a diagnosis, and are assist feeding him every couple of hours.

I am going to send an email to Karrie and Maverick who is a member here and who knows a lot about assist feeding and will provide you with a link to the Feline Assisted Feeding group, which I highly recommend you join and ask questions to.
 
Maverick survived FHL in 2008 and he would not have lived if it were not for the Feline Assisted Feeding forum. Maverick's story is in my signature of this post.

The cornerstones to FHL recovery are:
1. CALORIES - enough to at a minimum maintain his weight. The FAF group will help you with syringe feeding or other methods of assist feeding. MaxCal was worth its weight in gold at 330 calories a can and only 3-6% carbs. Do you have a baby scale you can borrow from someone to make sure you are feeding enough?
2. Antinausea medication. FHL is horribly nauseating. Ondansetron is a MUST! It can be purchased from thrivingpets online at only 80cents per 4mg pill which is 4 doses. When you join FAF you will be able to view a file on nausea where you can come up to speed and get your vet to prescribe this. My Dad got liver disease a year after Maverick recovered and my dad was able to verbalize how horrible it made him feel. He didn't eat for six weeks before he finally went to a doctor and got diagnosed.

When you post your introduction on FAF give your cats full history - why he/she stopped eating - any stressors in the home? changes in food?

A feeding tube actually would be a life saver if you can't get enough food into him any other way. There are cats here that could only recover with a feeding tube as they were in a diabetic keto acidosis crisis. Feeding tubes are short term. We'll cross this bridge if we come to it though.

So glad you found the FDMB. I could not imagine managing Maverick's diabetes without them. I've met many people I consider real friends on this board also. It is unlike any place I've found on the web.

You are very lucky your cat has FHL which is something he can fully recover from.

Here is the link to the FAF forum. Please read the autofiles that you will be sent. There are also files and links with great information and a video of a Toady being syringe fed on our home page.

http://pets.groups.yahoo.com/group/Feline-Assisted-Feeding/

Do to how hectic my life has become recently I can't be on FDMB very much. The FAF group has members from around the world and is a very active group. You will get lots of help on assist feeding and recovery from FHL there. They are not diabetes experts - this is for FDMB. Make sure you keep this group posted so they can flag anything that doesn't mesh with diabetes treatment. For example clinicare is a liquid food but its 27% carbs.

Sending hugs.

Karrie and angel Maverick.
 
Thanks Karrie :YMHUG:

I hope you will join the group that Karrie suggests.

My diabetic kitty had DKA and came home from the hospital with a feeding tube. He would not eat while at the vets and he was there for 8 and 1/2 days. So, the feeding tube was a life saver for him. You can help save his life with syringe feeding too, it's just a little harder or more time consuming, I think (I'm not no expert, and I don't have near the experience that Karrie has). The assisted feeding group I'm sure will help you with any questions you may have, about how to do it, how much to give and how fast to give it, and what to feed, etc, etc.

Iams Maximum Calorie (MaxCal) is over 300 calories per can and 6% carbs or something like that, so good for diabetics and getting the maximum calories into your cat. Karrie, correct me if I am wrong about the calories and carbs.
 
Thanks for all the help! I will check out that group. The vet recommended I feed him meat baby food, as it is low in carbs and a good consistency for the syringe feeder. It looks like to maintain his weight, I need to feed him around 3-4 2.5 oz jars of that a day. He's taken to the syringe pretty well, so I was able to get 2 oz into him last night and another 2 oz this morning. I just got back from work, so I plan to try for at least 2 oz more today and preferably 4 oz. Starting tomorrow the goal is 6-8 oz a day. We're working our way up.

The vet also said that if he looks dehydrated in a couple days again, I could bring him back for more sub-cu fluids at no charge. They wrote me out very specific guidelines to coordinate his feeding and insulin management, and they have been available by phone as well. I'm hoping he makes a full recovery. He's such a sweet boy and has been through so much.
 
Your vet is amazing. Please educate yourself on the ondansetron and make the best efforts to get this prescribed by your vet. I couldn't imagine recovering from FHL without it. My dad ate solid foods the first day he got an injection of anti nausea medication for his liver failure. It is night and day. My dad said that on top of the nausea, the liver disease made his taste buds taste a 1000% too sensitive. I wonder if this is the same for cats also. Let me know when you join and I'll email you the link to the nausea and FHL files. You can't read them if you aren't a member.

How many calories is in 4 jars of meat baby food? MaxCal I think is the best you can buy for FHL recovery if this is the ony thing he is recovering from. If he has pancreatitis flare like a lot of diabetic cats do get - this wouldn't be ideal. But at 330 calories for a 5oz can it is amazing. Every cat is different though. Maverick needed a ton of calories to maintain his weight when he was recovering from FHL. I could not have fed enough of any other food. But once he started feeling better and his liver numbers improved, he needed less and less calories to maintain.
 
I will ask them about anti-nausea meds. He hasn't been vomiting, but definitely feeling sick to his stomach would discourage him from eating. They also prescribed an appetite stimulant. The baby food is about 80 cal for a 2.5 oz jar. Arthur is already underweight; he used to weigh about 11 lbs, but between the ketoacidosis and then this, he's dropped down to about 8.5 lbs.
 
DO NOT give an appetite stimulant to an FHL cat. FHL is horribly nauseating and it would be like giving you an appetite stimulant with the flu. It won't help and can lead to long term food aversion issues. Focus on assist feeding the calories and getting an antinausea medication. He will eat when he is feeling better.

Signs of nausea include lip licking, lip smacking, teeth grinding, hovering over the water bowl, swallowing, and a classic sign is showing interest in food but just licking or sniffing and walking away. The nausea article I will link to will explain nausea, causes and treatments in more depth.
 
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