Xmas emergency: Sick cat = still give insulin injection?

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SeanLegion

Member Since 2013
My DB cat usually eats his prepared meal every 12 hours followed by his insulin injection.
Just before dinner time (about 2.5hrs ago), he has been sick = vomited old food, used the litterbox for everything... twice, a couple bile/foam barfs, and now does not want water or food.
When he was diagnosed a year ago he was drinking water excessively, but is showing no signs now of being thirsty other than being lethargic with his tongue part out & sometimes panting. Tried water in an eyedropper to his mouth which he was not interested in swallowing.
With no sign of eating anytime soon, should he still get his injection without a meal?
Will an insulin shot make him worse right now?
Is he badly in need of insulin right now, regardless of food or not?

Do I have to call the vet after 9pm on Christmas for an emergency visit that can't be afforded?
 
Sean
What kind of insulin? What's his normal dose, and are you home testing so you know what his blood glucose is right now?

Could he have eaten anything that might have caused the vomiting (other than food) like part of a plant? You said he vomited in the litterbox? Did he poop at the same time? Any way he might be consitpated (straining to go can cause vomiting sometimes).

The symptom that catches my eye is "panting". Did that just start after him vomiting?
 
If his breath smells like nail polish remover, he may be in diabetic ketoacidosis, a potentially fatal complication of diabetes. It cannot be treated at home. Panting can be the body's way of trying to compensate for the acid build up.
 
The insulin is Lantus = 2 units twice daily after prepared meals.
Have never had or done any home testing for blood glucose levels.

He did not eat anything other than his past food to make him sick.
Vomit was dry food from earlier in the day - did not happen in litterbox area.
The panting, bit of drool/foam slight spell was probably for about 20-30min after being sick a couple times.
3 times to the litterbox since sick were: 1/2 a poo & pee in box, (followed by 1/2 poo in his bed while vomiting bile/foam), wet poo in box, then moved to the recliner to lay & pant. After all that and not wanting my water options for him he was resting looking unwell & lethargic, then recently a quick jump off the recliner to go pee in the box.
Now he is back in the recliner curled up in a sweater apparently content to try and sleep it off for a while... without food, water, medicine, or attention.
Maybe he wakes up in an hour or so and goes straight to his big water bowl for a drink, then starts asking for dinner.
 
Recap/check
Feeding both dry and canned food
Vomiting/not eating, nor drinking

Vomiting can be a sign of excessive ketone buildup. Ketones form as a by-product of fat breakdown for calories, when the insulin:glucose ratio is not balanced.

You may be safe shooting 1 unit, half of what he is on, if he does not eat. This is what some vets recommend the morning of a procedure when the cat is fasting.

As soon as possible, if you want to keep your long term costs down and your cat safe, you need to pick up an inexpensive human glucometer sucy as the WalMart ReliOn Confirm, Confirm Micro, or Prime, test strips for the meter, and lancets to poke the outer edge of the ear, or the paw pad to get a drop of blood for testing. Avoid meters with True of Free in the name as they don't do well for cats.

Also see my signature link Secondary Monitoring Tools for additional assessments you can make to evaluate your cat's health.
 
No way to know for sure what exactly is causing this.
Could be ketones.
Could be either high or low BG at the moment.

Short term -
Continue to watch him.
Seriously consider home testing BG so there's no doubt what the BG is at any point in time.
Pick up some urine ketone test strips.
Call the vet first thing in the AM.

Did you smell his breath?

Panting can also be a sign of pain.

I would skip the shot IF you can call first thing and get an appointment with his vet. If it is ketones, your vet can address that better than you can. If it isn't ketones, skipping is less of a problem.

But you need to know what his BG looks like. Without that data, you can't tell if the dose is too high or too low. The home testing supplies will cost less than a blood test by your vet.
 
His nap was short, but has continued to just rest calmly (while pouting) in different positions, besides getting up once to pee again in the box.

Breath has been fine, and vomit did not smell.

I think I am going to give him the half dose mentioned despite no appetite, as I am not sure about an early morning vet appointment, and I don't want him to go 18-24 hours or more with no dose.

There has more than likely been too many calories without enough exercise as time has progressed resulting in the ketones buildup again.
It seems he has been getting a bit heavier and has been eating too much.

Fancy is about 13-14yrs old, VERY large (not just fat) 12-14lb, all black short haired male indoor cat.
 
He's a big boy like a couple of my civvies.

Pop by your local pharmacy today and get some urine test strips to check for ketone/glucose (KetoDiaStix - you may have to ask pharmacist for them).
- If ketones are detected at more than a trace, it is a medical emergency.
- If glucose is detected, it means there wasn't enough insulin since the previous void.
 
Thanks for all the help and advice.
Fancy got no sleep last night, mostly rapid breathing, resting, and trying to drink.
Today rested and drank a bit until we were able to get to the vet around 5pm.
He was diagnosed as dehydrated and got an IV that made him feel much better.
Instructions are to check-in with vet in the morning before maybe more IV, half dose of insulin tonight if he is still not eating a full meal.
He has eaten a small bit of dry food a few times today & since his IV, hoping for a larger appetite after he is rehydrated fully.
Apparently his vomiting of a past meal in combo with a few poops were signs of constipation and being backed up with too much food, which the vet said could be a common issue with DB cats.
Tomorrow they will do a ketone test if they think he needs it, and we will discuss options for BG checking.

*Note on Fancy weight: pretty much about the same for the past decade, although not the 12-14lbs listed before... that was the weight from his visit 1yr ago, but I knew then it was not at all correct.
He is a VERY big boy and really not too fat. Kind of like a semi-domesticated pygmy panther.
His weight on the scale today at the vet is 19+lbs = the vet agreed that he is about the same as last visit and the scale was wrong last time.
 
Got some more reading for you!

Here is the Feline Constipation web site. It explains more than you ever thought you'd need to know about the feline GI tract, plus ways to manage constipation.

Cat Info, written by Dr Lisa Pierson, explains basic feline nutrition. Cats are obligate carnivores and should eat a protein based diet, not cereal (most dry food is 30-40% calories from carbohydrates). The downloadable food list provides nutrition info for a wide variety of over the counter foods so you can select low carb foods without needing a prescription. Friskies pates and Fancy Feast Classic pates are just 2 varieties that may be fed.

It is not necessary to feed a prescription high fiber diet to avoid constipation or to manage diabetes. Low carb canned or raw food, possibly with an added 1/8 to 1/4 teaspoon of plain psyllium fiber to hold water in the stool and give it some bulk, plus a tablespoon or so of water can do it.
 
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