Vomiting Re-Posting

[Louellen]

I'm re-posting this as a 911 because now I'm becoming really concerned.

Morrigan vomited a fur ball this afternoon. (It was definitely a fur ball as I quadruple checked) She's eaten maybe, 2 3 oz cans of food today but, she doesn't seem herself since and isn't interested in food. She nibbled on a couple of her favourite (though not sanctified carb wise) treats but, stopped.

I just took her blood glucose @+9.5 and it's not out of range for her but, a little higher than usual for this time of night at 14.5 (261).

Other than the fur ball vomit, (several hours ago now), she's urinated and had a bowel movement (normal).

But, she just vomited again...the tiny pieces of treats that she JUST ate. Now I'm really concerned!

Please answer as to what to do.

 

[BJM]

When the GI tract is upset, vets generally suggest a short trial of rest - don't push the food, and make sure there is plenty of fresh cool water available. If no eating overnight, contact your vet.
You might also consider 1/4 of a 10 mg Pepcid AC (no other active ingredients, just the Pepcid part). Wait 20 minutes or so before offering food.

Check my signature link Secondary Monitoring Tools for some other assessments you can make to evaluate her.

 

[Louellen]

When the GI tract is upset, vets generally suggest a trial of rest - don't push the food, and make sure there is plenty of fresh cool water available.
You might also consider 1/4 of a 10 mg Pepcid AC (no other active ingredients, just the Pepcid part). Wait 20 minutes or so before offering food.

Ok, thanks BJ...I have no Pepcid AC but, will send hubby out to get some.
So, if she's not eating anymore tonight....should I skip the insulin? I do have, ironically, a vet appt. tomorrow in the late afternoon.
I'm concerned because she just vomited up some of the 2 pieces of treat she ate and is pretty low-key/lethargic seeming in spite of her glucose not being that far out of range.

 

[Angela]

Spaz will sometimes vomit a couple of times if he's working out a hairball-usually the hairball then some clear bile (sometimes in the opposite order). The bile will sometimes contain a bit of u digested food if he just ate.
Hopefully Morrigan is just working out some left over fur in his stomach .

 

[Louellen]

Spaz will sometimes vomit a couple of times if he's working out a hairball-usually the hairball then some clear bile (sometimes in the opposite order). The bile will sometimes contain a bit of u digested food if he just ate.
Hopefully Morrigan is just working out some left over fur in his stomach .

Thanks, Angela...does Spaz also seem to refuse food and seem "not himself" afterwards?

 

[BJM]

Is the glucose as high as normal? If yes, maybe a half dose just to keep it from zooming up. If much higher than normal, you might give the regular 1.0 unit, or 0.75 units.

 

[Louellen]

Is the glucose as high as normal? If yes, maybe a half dose just to keep it from zooming up. If much higher than normal, you might give the regular 1.0 unit, or 0.75 units.

Her glucose is just a bit higher than normal for this time of night but, not out of range for her. I was told not to give insulin if she's not eating but, I'm lost as to what to do since I doubt she is going to look at food by the time I should be giving her the shot in about an hour or so.

 

[Angela]

Spaz will actuallys eat-even when he's not hungry. But to be honest I'm not too sure about his appetite after vomiting as he usually waits until 3am to do so-at that time of the morning I'm not awake enough to check if he's eating. I just clean up the mess and go back to bed!
He does tend to keep to himself for a while after vomiting though which is different from his usual behaviour-he's a very codependent cat.

 

[Louellen]

Thanks Angela. Normally, I wouldn't be so concerned over this. I'd wait and see type of thing but, because of the diabetes and having to give insulin....I'm a little panicked...no...make that really panicked!

 

[BJM]

He may be OK. Just let him rest overnight and take it up with the vet at the appointment if he still isn't eating by morning. Also, pick up some U-100 syringes, so you can shoot less than 1 unit at times like these - stuff happens!

 

[Angela]

I completely understand, I'd be worried too if I was in your shoes. Hopefly he's just having an off day and will be back to eating tomorrow.

 

[Brashworks]

Hey Louellen, can't give you any advice, just thinking positive thoughts for Morrigan. Keep us posted on how she does at the vet's tomorrow.

 

[Louellen]

Thank you all...
I was outside, sitting with her. She wanted to be outside on a comfy chair. She's certainly not herself.
So, I'm thinking that I may skip her shot tonight, let her stomach rest, watch her carefully and if anything else develops, take her to an emergency clinic (hoping that's not necessary as I can't afford it right now but, would do so if I'm not liking what I'm seeing).

BJ, I will let her rest, offer her food, if she doesn't want it, leave her be and wait until the morning to see how she is doing. If she's not better, I'm going ask to bring her into her regular vet earlier than the scheduled appt. time, if possible. And, I will pick up syringes tomorrow.

Oh, I hate this. I'm a worrier (as you can tell) so, this is really playing on anxiety levels. If she weren't diabetic, I wouldn't be so panicked.

 

[BJM]

Have you checked the urine for ketones?
Is she dehydrated (via scruff test and gum test in my Secondary Monitoring Tools)?
Does her breath smell fruity or like nail polish remover?

 

[Louellen]

Have you checked the urine for ketones?
Is she dehydrated (via scruff test and gum test in my Secondary Monitoring Tools)?
Does her breath smell fruity or like nail polish remover?

I don't have keytone sticks but, I checked her breath and it smells normal.

 

[Louellen]

I haven't checked her for dehydration yet but, hubby is offering her some watered down canned food and she's not looking at it.
I will check her for dehydration.

 

[Louellen]

UPDATE: She's picked up a bit in terms of purring a bit and wanting to be around us but, has only eaten 4 tsps of canned food (mixed with bottled water) over the past 12 hours or so. I gave NO insulin last night or this morning as she was at 190/10.6 this morning (24 hrs after last dose given).

I called the vet and he's saying to keep the appointment for 4 this afternoon, knowing what's going on (I had asked for sooner).

I'm quite worried and concerned that a fur ball vomit shouldn't cause this much of a disruption...especially given that it was about 18 hours or so ago???? Anyone else have this happen?

 

[Jill & Alex (GA)]

I'm quite worried and concerned that a fur ball vomit shouldn't cause this much of a disruption...especially given that it was about 18 hours or so ago????

I agree and would be concerned for the same reasons as you. I'm glad you have a vet appointment this afternoon.

Have you picked up syringes yet? U100 3/10cc syringes with half unit markings are the best to use for fine dosing. BD, Monoject, GNP, and ReliOn are some of the brands available with half unit markings. Needle gauge and length is your preference They come in ½ inch or 5/16 inch needle lengths. Needle gauges 29, 30 or 31 (31 being the thinnest). While you're there you'll want to pickup some Ketostix to measure ketones in her urine... if you don't have any. Follow the directions on the cannister.

Here's where my concern lies today: You've already skipped 2 shots and Morrigan isn't eating. The recipe for ketones developing is an insufficient amount of insulin + inappetence + certain other systemic stresses. In other words, the stage is set for developing ketones. Once ketones develop the situation can rapidly advance to diabetic ketoacidosis (DKA).

You'll need to get some insulin into her tonight. Syringes will afford you the flexibility and ability to administer more or less than whole units of insulin. Ketostix strips will allow you to catch potential problems before they become life-threatening.

Here's more info for you to read: Ketones, Diabetic Ketoacidosis (DKA), and Blood Ketone Meters

Good luck at the vet. Hope you get the answers you need.
Update when you can...

 

[Louellen]

Thank you Jill & Alex....I do have a couple of syringes now from the vet and he doesn't feel concerned...though I am not convinced not to be. She's eating very little right now (maybe, a couple of tsps throughout the day). He checked her for dehydration and said she wasn't, took blood, told me to feed her whatever she'll eat and give it another day to see how she does. I am going to take her glucose level again tonight (once she settles down as he also shaved her down to stop the fur balls) and unless really low, give her at least a half dose and TRY to get her to eat something...even if it isn't lowest in carbs.

He said he didn't at all think it was pancreatitis, felt her abdomen, checked her temp and all were normal, also checked her heart and lungs etc.. BUT..UNTIL I can see her eating more (she will eat higher carb treats very well)...I'm very concerned as to what to do and whether to feel ok or not. (Make that: SCARED SILLY).

She hasn't gone to the litter box today. Lack of eating? Yesterday, she went once (both urination and bowel movement). But, she hasn't vomited again since yesterday late afternoon. (Only the fur ball then, a bit of clear liquid).

I'm extremely worried. She is walking around and doing her usual stuff, just more guarded/low laying in doing them and this trip to the vet's today, set her off big time with anger and upset. (She holds grudges big time).

I am supposed to call him back tomorrow as to how she is doing and to get results from the blood tests he's run today. He said, "I'm NOT concerned"....yeah, but I AM! I'm a mess. I hope this all calms down. At least she'll entertain a bit of food today. Yesterday after the fur ball vomit...nothing.

 

[Tiger(GA) and Ruth]

I am so glad you brought her into the vet to get this checked out! Did your vet test for pancreatitis? The Spec fpl would be listed on your bill, it is the most accurate test. Sending feel better vines for your girl.

 

[Louellen]

I am so glad you brought her into the vet to get this checked out! Did your vet test for pancreatitis? The Spec fpl would be listed on your bill, it is the most accurate test. Sending feel better vines for your girl.

Thanks Tiger and Ruth...no...he didn't specifically test for pancreatitis but, he said that he'll see these initial results tomorrow and has taken enough blood to run additional tests if needed.

 

[Louellen]

I agree and would be concerned for the same reasons as you. I'm glad you have a vet appointment this afternoon.

Have you picked up syringes yet? U100 3/10cc syringes with half unit markings are the best to use for fine dosing. BD, Monoject, GNP, and ReliOn are some of the brands available with half unit markings. Needle gauge and length is your preference They come in ½ inch or 5/16 inch needle lengths. Needle gauges 29, 30 or 31 (31 being the thinnest). While you're there you'll want to pickup some Ketostix to measure ketones in her urine... if you don't have any. Follow the directions on the cannister.

Here's where my concern lies today: You've already skipped 2 shots and Morrigan isn't eating. The recipe for ketones developing is an insufficient amount of insulin + inappetence + certain other systemic stresses. In other words, the stage is set for developing ketones. Once ketones develop the situation can rapidly advance to diabetic ketoacidosis (DKA).

You'll need to get some insulin into her tonight. Syringes will afford you the flexibility and ability to administer more or less than whole units of insulin. Ketostix strips will allow you to catch potential problems before they become life-threatening.

Here's more info for you to read: Ketones, Diabetic Ketoacidosis (DKA), and Blood Ketone Meters

Good luck at the vet. Hope you get the answers you need.
Update when you can...

But, Jill & Alex...one more question....she's not eating MUCH at any one time (we are offering a tablespoon many times a day) and she will eat, 1, maybe 2 TEASPOONS of food (if that right now) at any one time so, given that...and that my Home Testing this morning for instance, was at 10.6 or 190 or so...what do I do about shooting? If there's not much eaten...doesn't that mean that the insulin could bring her into hypo territory?

I'm very concerned and scared and she hasn't used the litter box yet today for either so, getting ketone testing is nearly impossible.

 

[Jill & Alex (GA)]

I do have a couple of syringes now from the vet...

Double check to make sure they're U-100 syringes. Vets are notorious for handing out the wrong syringes when one is using a human insulin like Lantus or Levemir.

I am going to take her glucose level again tonight (once she settles down as he also shaved her down to stop the fur balls) and unless really low, give her at least a half dose and TRY to get her to eat something...even if it isn't lowest in carbs.

I'm glad he mentioned to get her to eat something even if it isn't low carb. The important thing is to get her to eat... no matter what it is.

He said he didn't at all think it was pancreatitis, felt her abdomen, checked her temp and all were normal, also checked her heart and lungs etc.. BUT..UNTIL I can see her eating more (she will eat higher carb treats very well)...I'm very concerned as to what to do and whether to feel ok or not. (Make that: SCARED SILLY).

Try not to get too worried. She may be picking up on your emotions. You've had her checked out. You're getting her to eat some. I see you felt comfortable giving her insulin last night. These are all good things. Continue coaxing her to eat, monitoring, and recording your observations. How'd she do with insulin on board? How low did she drop?

She hasn't gone to the litter box today. Lack of eating?

Maybe. Do you think she might be constipated? If any of mine get constipated they'll often vomit and not want to eat.

no...he didn't specifically test for pancreatitis but, he said that he'll see these initial results tomorrow and has taken enough blood to run additional tests if needed.

Ruth brought up a good point. So many of our kitties have p-titis. It might not be a bad idea to have her tested for it.

...what do I do about shooting? If there's not much eaten...doesn't that mean that the insulin could bring her into hypo territory?

You want to shoot as much of her dose as you're comfortable with. Your schedule... your ability to monitor... your ability to get food into her (up to and including syringe feeding)... these are all factors you'll have to weigh when making dosing decisions because yes, administering exogenous insulin could drop her numbers into hypo territory. Our BG meters are one of the best tools we have to help keep our kitties safe.

I'm very concerned and scared and she hasn't used the litter box yet today for either so, getting ketone testing is nearly impossible.

Looks like she's urinated twice since you wrote this. That'll make it easier to sneak in a test for ketones when you can today.

I'll be out most of the day, but will check back with you later. If you have questions you can always start a new thread here on Health. There are many members who can help. You can also post in the Lantus and Levemir Insulin Support Group if you'd like.

Hope Morrigan is feeling better today!

 

[Louellen]

Double check to make sure they're U-100 syringes. Vets are notorious for handing out the wrong syringes when one is using a human insulin like Lantus or Levemir.


I'm glad he mentioned to get her to eat something even if it isn't low carb. The important thing is to get her to eat... no matter what it is.


Try not to get too worried. She may be picking up on your emotions. You've had her checked out. You're getting her to eat some. I see you felt comfortable giving her insulin last night. These are all good things. Continue coaxing her to eat, monitoring, and recording your observations. How'd she do with insulin on board? How low did she drop?


Maybe. Do you think she might be constipated? If any of mine get constipated they'll often vomit and not want to eat.


Ruth brought up a good point. So many of our kitties have p-titis. It might not be a bad idea to have her tested for it.


You want to shoot as much of her dose as you're comfortable with. Your schedule... your ability to monitor... your ability to get food into her (up to and including syringe feeding)... these are all factors you'll have to weigh when making dosing decisions because yes, administering exogenous insulin could drop her numbers into hypo territory. Our BG meters are one of the best tools we have to help keep our kitties safe.


Looks like she's urinated twice since you wrote this. That'll make it easier to sneak in a test for ketones when you can today.

I'll be out most of the day, but will check back with you later. If you have questions you can always start a new thread here on Health. There are many members who can help. You can also post in the Lantus and Levemir Insulin Support Group if you'd like.

Hope Morrigan is feeling better today!

Thank you, Jill & Alex! Yes, she finally pee'd and then again this morning (her new norm since insulin has been twice a day and cups not lakes)...then, she also had a MASSIVE bowel movement (normal..just a LOT) so, you very well could be correct that she was rather "loaded up" in that dept.. I'm also hoping that any potential remaining fur (which started the whole episode with a fur ball vomit) may have passed in that movement...*IF* there was any still there???

She wouldn't entertain much in the way of eating canned foods but, she wanted her m/d kibble and though I JUST managed to get her totally off of kibble for 3 days before this episode, (she was only eating less than 1/8th cup so, I could finally take it away totally) she only wanted that so, I'm letting her have it and continuing to give her canned foods FIRST with FortiFlora sprinkled on it (usually works but, not much this time). If she won't eat the canned, I wait a bit, try again and then finally, wanting her to eat something...give in and give the kibble. She's MUCH more active and brighter today (and cantankerous...her usual demeanour). I had to poke her twice today to get a reading (doesn't want to bleed much today and is taking 2 of us to hold her to try!!! YIKES!!!) But, I got it and naturally, having skipped 2 doses and eating m/d kibble again, she's got higher numbers.

So, I am waiting for those test results to come back (likely not until later today as it was late in the afternoon yesterday tests were done) and going to fill him in (though he has a link to her SS as well as my notes) and see what he says. I will also ask about the pancreatitis testing and see whether he wants to run it or not since he did take extra blood for extra tests if needed/wanted.

But, if all is well, I am going to continue to get her to eat something, somehow and give her insulin, test and hopefully, work my way back with her to normal eating and routines and canned foods solely. That's my plan and hope!

 

[Jill & Alex (GA)]

But, if all is well, I am going to continue to get her to eat something, somehow and give her insulin, test and hopefully, work my way back with her to normal eating and routines and canned foods solely. That's my plan and hope!

Sounds good! I'm sure you'll have her back on track in no time!

You might find some helpful tips in this post: Suggestions on How to Stimulate Kitty's Appetite.