Update on Gem

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JenM92

JenM92

Member Since 2020
Hi everyone,

It's been a while since my last post, I felt like we were making some progress with Gem, but there's been a ton of regression recently.

We are still trying to get her glucose down, and we are up to 8 units of Lantus twice a day. Gem has put on a bit of weight but is currently 3.6 kg and needs to be around 4.5 kg. The last few weeks she has had a much better energy level, she was eating consistently and I felt some light at the end of this tunnel.

Unfortunately, I brought her into the vet Tuesday for what I thought was maybe an eye infection, got some drops and went about our business. Yesterday (Friday) she had breakfast and that was it for food. Typically, she's a bowl cleaner. She was lethargic and I felt something wasn't right. After an emergency trip to the vet and a hospitalization over night, we have some concerns. The vet did full testing (blood work, urine sample, x rays) and found she was fairly significantly constipated and a UTI. She was on fluids and antibiotics last night and given a kitty enema. I brought her home today with antibiotics to give her and we are lowering her insulin to 5 units twice a day. The vet was concerned her UTI was throwing her numbers off and doesn't want her to hit a low. He is also considering it may be something more serious preventing the insulin from doing its job, like a GI cancer.
....it was a very long night.

Getting her home, I immediately fed her the new food they wanted me to try (hills m/d wet food) which she gobbled right up after not eating for about 24 hours. That was around noon.

Since then, she has done what she did Friday which is lick the food a bit and walk away. I've opened about 7 different types of wet food I have on hand and she's just not interested. I may very well give the vet another call once dinner/insulin time comes around if she's not eating. Any suggestions? I've tried water in the bowl, a touch of cream with her food, nada. Very unlike her, she typically loves her food.
I'm certainly hitting a point where I feel like I can't help her, and it's breaking my heart. I'm desperate to get this kitty well.

Thanks everyone.
(PS, we are home testing with the alphatrax machine. We've done numerous curves with the increases in insulin and we're averaging about 21 on the alphatrax meter)
 
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A kitty that licks their food then walks away is probably nauseous. Ive not much experience with this sort of thing... I'm going to tag someone that does
@Aleluia Grugru & Minnie

It will be hard to advise without a spreadsheet. Do you have one? In case you are interested here are the instructions:

FDMB SPREADSHEET INSTRUCTIONS

I hope this helps. I need to step away but will come back to check on you.
While your waiting please give Gem some scritches from all of us:bighug:
jeanne
 
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Thanks for the fast reply! I do not have a spreadsheet but let me get that downloaded and see if I can figure it out!

I was wondering about nausea as well, considering what she went through. I typically give her dinner and insulin between 6 and 7, so we have a bit of time. Luckily the emerg vet is amazing with a capital A and I know I can give them a call if I'm that worried. But I know the folks here are full of fabulous information ❤️
 
Hi Jenna,

Here's a guide to using the spreadsheet:

Understanding the spreadsheet grid

Did the ER vet give you anything to treat Gem for nausea at home? Here is a handy checklist of what symptoms to look for:

Nausea checklist

If Gem is nauseated then, assuming she's not constipated, anti-nausea meds (Cerenia, ondansetron) could help her to start eating again (although you'll still need to determine and treat the underlying cause of the nausea). Constipation can also cause a cat to be reluctant to eat, or even vomit. Constipation needs to be treated before anti-nausea meds will be properly effective. For safety, it's recommended to have a vet make sure there's no obstruction in the gut before starting any treatments for constipation.

Did the ER vet test for pancreatitis? Also, did they test Gem for ketones?

Do you have urine ketone test strips at home? If yes, as a really important safety precaution I'd recommend testing once a day at minimum for the time being. (Infection present, not eating properly, lowered insulin dose - this trio increases the risk of a kitty starting to produce ketones.)

Tips for collecting urine samples

If you don't yet have any, you can pick up urine ketone test strips at Walmarts or any human pharmacy. If a result is higher than 'Trace' then immediate veterinary treatment is needed. (Throwing ketones is a medical emergency. Catching them early can help prevent diabetic ketoacidosis.)


Mogs
.
 
Critter Mom said:
Hi Jenna,

Here's a guide to using the spreadsheet:

Understanding the spreadsheet grid

Did the ER vet give you anything to treat Gem for nausea at home? Here is a handy checklist of what symptoms to look for:

Nausea checklist

If Gem is nauseated then, assuming she's not constipated, anti-nausea meds (Cerenia, ondansetron) could help her to start eating again (although you'll still need to determine and treat the underlying cause of the nausea). Constipation can also cause a cat to be reluctant to eat, or even vomit. Constipation needs to be treated before anti-nausea meds will be properly effective. For safety, it's recommended to have a vet make sure there's no obstruction in the gut before starting any treatments for constipation.

Did the ER vet test for pancreatitis? Also, did they test Gem for ketones?

Do you have urine ketone test strips at home? If yes, as a really important safety precaution I'd recommend testing once a day at minimum for the time being. (Infection present, not eating properly, lowered insulin dose - this trio increases the risk of a kitty starting to produce ketones.)

Tips for collecting urine samples

If you don't yet have any, you can pick up urine ketone test strips at Walmarts or any human pharmacy. If a result is higher than 'Trace' then immediate veterinary treatment is needed. (Throwing ketones is a medical emergency. Catching them early can help prevent diabetic ketoacidosis.)


Mogs
.
Click to expand...
Thanks so much for this! She was very constipated when I took her in last night and they did an enema for her to clear that out. She is also on antibiotics so nausea was my first thought as well. I was not given an antinausea med but I am going to call and inquire about one I think. They did test for ketones and pancreatitis and that was negative for both.

I just got off the phone with the emerg vet and the nurse is going to be calling me back once they have a chance. Gem is having a good sleep right now so I think I'll just hold off on the antibiotic and perhaps the insulin as well.
I do not have the test strips for ketones at home, but I will check into those, thanks!!
 
Good morning from West coast BC!

I wish I had better news here but still struggling with getting poor Gem to eat. She managed a couple of her freeze dried treats last night and this morning, that was it. Typically she's up when my 6:30 alarm goes off instructing me to get my butt downstairs for her food. She was waiting in the kitchen looking eager to eat, but 4 different options and we have no dice. I took her glucose before hand and she's at 27, which is quite high. However the emerg vet did lower her Lantus by 3 units (we were at 8, he wanted down to 5 with the antibiotics in case that dropped her down). So I went ahead with her 5 units and managed to get the antibiotic down. Just monitoring her closely right now. But we haven't had a trip to the litter box and she's really just been doing a lot of sleeping.

The nurse at the vet's office did call me back last night and said to monitor and give them a call today if I was still concerned, which I am and I think I will be doing to look at an antinausea med. Crossing some fingers we get some normalcy back here and soon. I hate not seeing her like herself.

PS, I'm going to give the spreadsheet another go today, admittedly I didn't have the brain power to try and figure it out after our sh*t night Friday
 
Hi Jenna,

I see that Gem hasn't been to the loo for a while. When you call the vets I suggest asking whether they could test for blood ketones if you were able to take her in for a checkup. Blood ketone meters work just like glucometers with a blood droplet from the ear. If the vets have one available it would be very quick to check Gem to make sure she's safe on the ketone front. If push came to shove they might be able to express some urine from the bladder or else do a blood draw to check ketone levels.

Be sure to let us know how you get on with the vets.


Mogs
.
 
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