? What is going on?? over 400 by evening shot :(

Charity & Cap

Charity & Cap

Member
I need some guidance.

Cap's numbers have been bouncing around like crazy for the last couple of weeks. Sometimes in 200, more often in upper 300, skyrocketing into 400+ some nights, with very little variation on my end. I've taken to giving him slightly more than 2 if he's over 400 just to bring him down.

But WHAT is going on?? I'm so frustrated! :(

Food-wise, he's been eating fresh cooked salmon in the mornings. Either baby food (chicken in chicken broth) in the PM, or FF Flaked Trout, sometimes FF Chicken Pate, once he had FF chopped grill feast pate and liked it, but of course when I bought more, he hated it. Some days he wants to eat midday (either Dr. Elsey's chicken/turkey dry food) or a little deli meat (no sugar, usually turkey) or a bit more salmon.

He twisted his body the other day and landed wrong, and has a minor limp, but I don't know if that could destabilize him this much. I have been gone on and off, and those are the days he seems to head for 400, but he's hit it a few times when I've been home and coaxing him to eat. There's also a stray cat around, and my other cat fusses at him through the window, which could be causing him stress -- but it seems like whenever I give him 2, he starts climbing; if I give him 2.25, he goes back down.

No keytones in his urine. Been alternating his shot place (sometimes near the shoulders, sometimes in the soft skin of his tummy). He gets about a tablespoon of cream after his shot, since that's the only treat he eats.

What should I do?
Take him to the vet for tests?
Remove the dry food altogether to see if that changes it?
Give him 2 in the morning regardless of what his number might be and do a curve?

Help. :(
 
Oh wow…. I was hoping there might be some tests on his spreadsheet so I could decipher what’s been happening, but I honestly can’t tell anything with just preshot tests. It “looks” like he may need more insulin, but that can be very deceiving because he could be getting decent nadirs and we don’t know it. Personally, I would never increase insulin based on preshot tests alone. Preshot tests just tell us where his BG is without insulin acting very strongly (because most, if not all, of its action has worn off by preshot time.). The only use of a preshot test is so that we can tell the difference between preshot and nadir so we know what the dose is actually doing — and also to catch the occasional lower preshot that you will see with PeoZinc (also important information.)
 
The most informative tests are when you can try to catch his nadir on different days. It’s even better than doing a curve if you can get a +4 one day and a +6 another day, etc. Are you never at home after he gets his shots? I don’t know about your work schedule, but I recall that it varies sometimes?
 
Suzanne & Darcy said:
The most informative tests are when you can try to catch his nadir on different days. It’s even better than doing a curve if you can get a +4 one day and a +6 another day, etc. Are you never at home after he gets his shots? I don’t know about your work schedule, but I recall that it varies sometimes?
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I can try for 4 today and 6 tomorrow.

Doesn't it indicate that his nadir isn't any good if he's already at 400 by the PM test?
 
Charity & Cap said:
Doesn't it indicate that his nadir isn't any good if he's already at 400 by the PM test?
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Not necessarily. It just means that either his body went into a number that is lower than he is used to (so he went high as a reaction to that) or it could also just be that the insulin is wearing off more quickly than we would like. It can also be that he did not have a very good nadir and then the insulin wore off by PMPS time and he went even higher. Those are some of the possibilities.
 
He either had only dropped a moderate amount of points by 4 hours after his shot, or went low and rebounded and was climbing already, since he was at 310>278.

I gave him 2 tonight (almost up to 400 again) and will check him tomorrow; should it be the same time (9am / 4 hours after the shot) or do you want one at 5 or 6? I should be home MOST of this week, hopefully, so I could give him random morning tests for a few days.
 
Did you really give 2.5 tonight or is that a typo? Get a nighttime test if you have done an increase — and he also had a lower preshot than normal.
 
It was a typo. I gave him 2.25.

He's at 208 this morning and not wanting to eat. I'll keep coaxing him but he may skip a dose if he remains uninterested in food.

If he does eat, should I give him 1? Or a 2?
 
What have you tried feeding him. He doesn’t have to eat a lot right now because ProZinc will take 2 hours to onset, but I would like to see him eat a couple of tablespoons if possible.
 
Suzanne & Darcy said:
What have you tried feeding him. He doesn’t have to eat a lot right now because ProZinc will take 2 hours to onset, but I would like to see him eat a couple of tablespoons if possible.
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He's refused four different kinds of food, lunch meat, baby food, dry food, etc. Only things I haven't tried are salmon (he refused it yesterday) and cream, which I hate to give him without a meal. I suppose I could try it, to see if it gets his taste buds going.
 
Does he need to be treated for nausea with something like Ondansetron (Zofran) or even Cerenia (less good for nausea but works in some cats). Having no appetite is not normal and there must be an underlying reason. Also, does he need an appetite stimulant like Mirataz/Mirtazapine or even Cyproheptadine?
 
Has he been to the vet for a full workup for having these bouts of low/no appetite. Things like inflammatory bowel disease, pancreatitis, kidney disease and a host of other things can cause inappetance.
 
Suzanne & Darcy said:
Question: how many hours before his shot time do you wake up? One hour? (PMPS +11) Two hours? (+PMPS +10)
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He gets food at 4:30 am and his shot around 5 when I'm sure he's eaten. I'm usually awake around 4:15.

As for nausea -- I don't know. I haven't had him tested for that. Nor for the appetite stimulant, since he's usually ravenous.

Didn't want cream either so I guess today is a no-go. :(
 
Yes. I'll be mostly home. I can wait around and see if he eats.

If it is pancreitus, kidney disease, etc, I'll have to put him to sleep. I can't afford it. :(
 
Charity & Cap said:
Yes. I'll be mostly home. I can wait around and see if he eats.

If it is pancreitus, kidney disease, etc, I'll have to put him to sleep. I can't afford it. :(
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It’s not that costly to get practical treatments for those diseases. The treatments are just things like anti nausea meds (Zofran/Ondansetron is not expensive at local pharmacies, giving sub-q fluids at home is not expensive when you buy supplies from somewhere like Chewy.com and not from the vet). Gabapentin (pain med for pancreatitis) is not particularly expensive. You would have to make your vet aware of the lack of appetite/sporadic appetite in order to get some meds. I would simply start with Ondansetron to see if it helps with his appetite on one of his bad days. Also, after that an appetite stimulant. A tube of Mirataz (ointment applied to the inner ear) lasts a long time.
 
Charity & Cap said:
If he does eventually eat, what do I do?

He's curled up asleep right now, so I doubt he will within an hour, but we'll see.
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If you stick a dish of kibble in front of his face, will he eat it?

I would retest his ear while he is asleep and see if his BG is going up. I hate to see him lose his good progress because of his lack of appetite. I am sorry. I understand what it’s like when our cats won’t eat. I have one at home who is absolutely driving me crazy. I am getting ready to go back home (out feeding feral cats now) and see if the Mirtazapine pill I gave him before I left the house at 6 a.m. has done anything to get him hungry. Sigh.
 
Suzanne & Darcy said:
If you stick a dish of kibble in front of his face, will he eat it?

I would retest his ear while he is asleep and see if his BG is going up. I hate to see him lose his good progress because of his lack of appetite. I am sorry. I understand what it’s like when our cats won’t eat. I have one at home who is absolutely driving me crazy. I am getting ready to go back home (out feeding feral cats now) and see if the Mirtazapine pill I gave him before I left the house at 6 a.m. has done anything to get him hungry. Sigh.
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He won't.

He laid on the bed for awhile, then got tired of me offering him food and is asleep under it.

I'll try again in an hour or two. Will test his ear later; he's annoyed at me.

But yeah, it's frustrating. You can't explain to the cat why they need to eat a couple of bites, or ask them if they're just not hungry or are feeling sick. I never know if he actually doesn't want food or if he's just not wanting anything I've got. But I tried the food he's not allowed to have, and he didn't want that either, so it might just be low blood sugar / not hungry.

Will check out those appetite meds and see if my vet will give one to me without having to take him in. :/

Hope your kitty feels better and eats soon!
 
He is willing to eat the dry food that he’s not supposed to have. It’s two hours late. It will spike his blood sugar but I’d rather have that then skip an insulin shot. He won’t let me test him again / runs away if I try. But how much should I give him today if he eats more than a few bites? 1.5?
 
Never mind. Didn’t eat enough.

Had an argument with my dad who thinks he should be on 1.5 because he was happy and had an appetite on it instead of trying to manage his numbers.

I don’t know what to do. Will try to talk to a vet.
 
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Spoke to my vet. She says get a mid-day test so we know where he's at, and she/her superior will call me back in a few hours.

He's FINALLY eating, after 7 hours. I'll test in a little bit, even though I know the food will spike it. Gives me hope he'll eat tonight as usual. ❤️
 
Just an update: Cap ate a little tonight, but since he's barely hungry the vet said only give him 1 unit. He'll talk to me in the morning. Managed to get him to drink a tiny bit of cream (yay for fat and calories) and now he's eating a little more dry food, so hopefully he'll be back to normal in the morning. Might still take him in to test for pancreitus / check all his blood work tomorrow, but if he's not "in danger" it can wait a few days.
 
Did he eat this morning? If so, one unit is not going to be nearly enough for him and he’s going to go really high (even more so if he’s eating high carb kibble.)
 
Suzanne & Darcy said:
Did he eat this morning? If so, one unit is not going to be nearly enough for him and he’s going to go really high (even more so if he’s eating high carb kibble.)
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He was under 300 and I didn't want to risk anything until after I can talk to the vet about dosing right now compared to his small appetite. I COULD give him .5 if you're worried about it, but it's been an hour since his dose. Don't know if that would mess with him.

He ate a little bit of baked salmon (maybe two or three tablespoons) but no dry food. I haven't given him access to the high carb kibble today; there is Dr. Elsey's out if he wants it, but he didn't want it.

ETA: He's acting more normal, but still a little subdued. He only ate a bit overnight / left most of what I left out for him. Not sure if he's bored with his usual 8pm snack or just not that hungry yet.
 
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It's an hour after his shot; he's eating more salmon.

Should I give him .5 when he's done?

I'm a little concerned about overdoing it, since his numbers have been so low the last 48 hours, and they don't seem to be doing their usual steep climb upwards. I fully expect high numbers in a day or two. :/
 
I hope he will start eating more normally soon. I am glad you gave him some insulin. He really should be in green and blue numbers by now, but even seeing some yellow numbers on the spreadsheet is better. I am worried about his lack of appetite.
 
Hopefully he’ll be eating normally by tonight. Otherwise he’s been acting pretty normal all day in terms of energy, wanting to socialize, exercising, etc. I’m just waiting for the vet to call me back to talk about tonight’s dose. 💖
 
Suzanne & Darcy said:
What’s his PMPS? Did you get any tests today on him?
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Not midday, so I'll be curious to see what it is when I test him in about 45 minutes for his PM shot.

I assume if he's 350+ I should give 2 units, and if he's not, 1.5 might be safer.

It's almost like he's storing up insulin and it's all being dumped after a few days into his system, but that's not possible. Right??
 
327. Vet said give him 1.5 tonight, and probably in the morning, then in the evening it might be safe to go back up to 2, depending on his numbers.

Eating normally, thank goodness. Good to hear him smacking his lips again.
 
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