*** LONG POST ALERT! ***
Good lord, NO!!! There are
lots of things you can do to help a cat who is off its food.
It may be that your little fella is nauseated. Some humans report that Lantus upsets their stomach and I have observed that some members' cats seem to become nauseated in the early days of insulin treatment. Also some cats may have undiagnosed chronic pancreatitis and that also may cause nausea.
First thing I'd suggest is to ring your vet for advice on how much insulin to give tonight - and be sure to let the vet know that your kitty appears to be quite lethargic. A starting dose of 1 unit of Lantus twice a day is in line with the dosingn guidelines for a cat weighing about 9-10lb (per Roomp-Rand published study) but if your little one is not eating enough you need to be extra careful that his BG does not go too low. If you could get a blood glucose meter straight away (e.g. Relion Confirm from Walmart - strips are affordable) we can help you learn to check his BG at home to make sure his BG is in a safe range. It's also important to get urine test strips to check his urine ketones (e.g. Keto-Diastix or Walmart's equivalent) to make sure your kitty is not throwing ketones because he's not eating enough at the moment. (For information, ketones can lead to diabetic ketoacidosis (DKA) - a major complication of diabetes which needs emergency veterinary treatment). Ketone build-up can also cause nausea and inappetence.
Here is a very helpful link to information on nausea and inappetence plus how to treat it:
Nausea, vomiting, excess stomach acid - symptoms and treatments
Licking the jelly off food is a very common clinical sign of nausea. Signs of abdominal discomfort may include squatting in a tense 'meatloaf' position, hiding (e.g. retreating under a bed or table), seeking out cool surfaces to lie on (e.g. tiled/stone flooring).
A Cerenia injection may be the fastest way to assist with the nausea (lasts about 24 hours). Ondansetron is another anti-nausea treatment (and I've found it a better anti-nausea treatment - generic is MUCH cheaper than the branded Zofran version) but it can take a day or so to reach full effect. Typical dose is 1mg twice a day (10lb cat) but a higher dose can be used if nausea is more severe. I would give my Saoirse 2mg twice a day for her nausea issues (chronic pancreatitis - 10lb cat).
Part of the problem with nausea can be a build-up of stomach acid when the kitty's tummy is empty. This may then lead to vomiting of liquid (sometimes yellow/brown, sometimes clear/foamy) in response to the stomach acidity (see above link for more info - it's written for cats with kidney issues but the symptoms are the same for cats with nausea and inappetence due to other GI issues). If you can manage to keep your kitty ingesting even small amounts of food very regularly that might help. Try mixing the food with water into a thick, soupy consistency and see whether your kitty might lick some from your fingers. If that works then try offering a bit more from the palm of your hand - the warmth from your hand and the reassurance of your presence may encourage him to eat a bit more. As has been suggested above plain meat baby food (NB: just meat and broth; no garlic, onion, or other ingredients harmful to cats). If you can get him to eat even a few teaspoonfuls of the food/water mix every hour it could help a lot.
An appetite stimulant may also help to keep your kitty eating but it really needs to be given in conjunction with anti-nausea treatment; partly because untreated nausea may stop the kitty eating in spite of the appetite stimulation plus it can also lead to kitty developing aversion to the food being offered and refusing to eat it in the future.
Here is a document about treatments for pancreatitis. Although it's written to address pancreatitis it has excellent advice on treatments for nausea and inappetence. It is very helpful as a guide to asking your vet for the right treatments:
IDEXX pancreatitis treatment guidelines
Your vet should be able to run blood tests to diagnose whether your kitty might have pancreatitis (SNAP fPl can give an immediate indication of whether pancreatic inflammation is likely to be present, or Spec fPL will be sent to external lab with results back in a few days). I do think it advisable to get your kitty checked by your vet as soon as possible. Ask the vet to check for discomfort/tension in the abdominal region and also to check whether there is any back pain (an inflamed pancreas can cause both). Should a pancreas flare be the problem it can be very painful. Buprenorphine can help a great deal with pain management and therefore appetite plus it can help the flare to resolve quicker.
Try to do what you can to get fluids into your kitty; dehydration can make them feel worse. If syringing fluids do it from the side of the mouth, ACROSS the mouth and very slowly to allow time for your kitty to swallow and to avoid aspirating fluids into the lungs. If you're not sure you can do this safely get him to the vets sooner for fluids.
Bring a sample of urine with you to the vets and ask them to check for ketones if you've not been able to do so yourself (critically important for a diabetic, especially when the cat is not eating enough).
I'm very disheartened by the suggestion of your friends to 'give up' if your kitty doesn't eat. Anti-nausea meds and appetite stimulants can help enormously (plus pain relief and other supportive meds if pancreatitis is the issue). For general info (not to scare you, just providing information) if inappetence is not responsive to meds it is possible to use a feeding tube to provide nourishment for a cat who is experiencing difficulty with eating. Here is a vet-authored article where you can learn more about them:
Feeding Tubes Can Save Lives - Dr Lisa Pierson
With regard to worries about treatment costs should more than supportive meds be needed please don't make any hasty decisions based on finances: there is a wonderful organisation called Diabetic Cats in Need who may be able to help you and your kitty with treatment costs. I'm tagging some members who may be able to give you further info on this. (
@Chris & China,
@Marje and Gracie)
Another thing to watch for is constipation as this may cause nausea, too. Given that your kitty has been diagnosed with neuropathy it may also be affecting his gut motility (diabetic gastroparesis). If the nausea is constipation-related then Cerenia and ondansetron are unlikely to be any help until the constipation is resolved. Again this is something to ask your vet to check for during the examination. A very
short course of metoclopramide (Reglan) can help to improve gut motility. (NB: Metoclopramide is not helpful as a nausea treatment
per se in cats as they have very few of the receptors it targets - see the IDEXX document above for more info on this. It should not be used long term because it can cause movement disorders.) Lots of information on the feline GI tract here:
www.felineconstipation.org
Sorry for the carpet bombing of information; I just want you to have information available to you so that you know about all of the effective treatments for feline inappetence. Your little fella is young; there are a lot of things that can help him.
Sending a little prayer for your kitty - and a lot of anti-nausea vibes.
Mogs
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