? ?!?! Not doing well

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Amanda & Ham, Feb 7, 2017.

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  1. Amanda & Ham

    Amanda & Ham Member

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    Ham is not doing well this morning!! He barfed up all of his dinner last night and has been very lethargic ever since.

    He doesn't want to eat or drink anything. He'll take a couple of steps then he lays down. I've checked his bg and the numbers are normal for him they're not low... not sure what to do.
     
  2. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    Does Ham seems to want to eat but then turns away?? If so this could be a sign of nausea.

    Are you testing the urine for ketones?? If you are and there is any more than a trace showing then it would be prudent to take him to the vet ASAP. Higher glucose levels, not eating and possibly an infection can lead to diabetic ketoacidosis (DKA) which can be quite serious.

    The other possibility is pancreatitis, which would require ant-nausea meds, pain relief and sub Q fluids.

    If Ham is still not doing well and refusing to eat a visit to the vet might be in order. :bighug:
     
  3. Amanda & Ham

    Amanda & Ham Member

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    No I am not testing for urine ketones. I don't know how or even what I'd need.

    No it seem he isn't interested in eating at all. I've tried food, cheese, and some milk and nothing.

    I was just looking for a new vet. I'm not really sure my current vet is well educated on cat diabetes, and one closer to home that won't take a half hour to get to.

    Ham has never turned away from food. He's trying to stay in dark places. I'm really worried.
     
  4. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    To test the urine for ketones you would need test strips such as :

    [​IMG]

    You would need to collect a small sample of the urine and dip the stick into it. The strips pictured above has two strips on it...one for glucose and one for ketones. On this type you read the results for the ketone after 15 seconds. If it shows any more than a trace of ketones then a visit ASAP to the vet/ER would be in order.

    The fact that he is refusing to eat and seems nauseous could be a sign of DKA or pancreatitis, both of which would require some medical intervention. The vomiting and lethargy can be signs of either one as well. If possible you should try to get him to the vet ASAP and have them check for ketones and a snap fPLI test which gives a yes or a no for pancreatitis. The snap test can be done in the office and gives results right away. The best test for pancreatitis needs to be sent to an outside lab but takes several days to get the results. Either one of these conditions can become serious very quickly and although there is no way to say for sure that either one of these is causing these problems it is best to be safe and have Ham checked.
     
  5. Amanda & Ham

    Amanda & Ham Member

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    He's going to the vet today!! I've already called off work so I can take him. Thank you for you help I will have the vet check.
     
  6. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    Good luck with the vet visit. The two things to make sure are okay are the ketones ( they can test that with either a urine test or blood test. The blood test is the most accurate) and the snap test for pancreatitis. There could certainly be other issues but you do want to rule those out for sure.

    :bighug: :bighug:


    ETA If you have a full blood panel it will help to check other areas, such as kidney function etc. If you do have the full blood work done it is useful to add the thyroid test as well to give a better overall picture.
     
  7. Dyana

    Dyana Well-Known Member

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    Best Of Luck at the vet.
    Please make sure the vet checks for ketones. I've read posts here too many time of vets dismissing ketones as something not to worry about :banghead:
     
  8. Amanda & Ham

    Amanda & Ham Member

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    Will do thanks
     
  9. Amanda & Ham

    Amanda & Ham Member

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    Ok so I called my normal vet and he said I don need to bring Ham in just give him an additional unit of insulin and again this evening. Now I have read in my research that you shouldn't give a cat insulin without them eating.
     
  10. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I think most of us here would suggest (strongly) that an actual vet visit is in order. Ketone status has to be checked along with assessment for pancreatitis and maybe meds given for nausea and appetite.
     
  11. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Amanda, DO NOT give insulin. You have Ham on a high dose. He needs to be seen by a vet to ensure he doesn't have ketones or pancreatitis. Both can lead to very serious and expensive conditions to deal with so if you can't get your vet to listen, please find another vet and take him there. I know you told your vet that you were using Toujeo but I'm still wondering if the vet really understands especially if he is telling you to give additional insulin when Ham is not eating at all. An additional unit of Toujeo is equivalent to 3u of Lantus. That is a huge increase for a cat who should be seen and possibly not given insulin at all right now.
     
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  12. Gill & George

    Gill & George Well-Known Member

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    What was his BG like this morning? Can't see anything on ss
    Are you using a pen needle, or a syringe to give the insulin?

    I think regardless of what his numbers are I would insist on taking him to the vets and having him run some tests, especially as him not eating is very unusual for him, my George never refuses food, if he were to refuse food I'd be at the vets in a flash.
     
  13. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

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    Adding my voice in strong support of taking him in. Don't take no for an answer on testing for ketones in particular-- DKA can progress extremely rapidly, and can be fatal. I don't want to scare you, but really, you don't want to take chances on things like this, nor do you want to take chances on heavily dosing your cat with extra insulin when he is not eating.
     
  14. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    For anyone following this thread, please note Amanda is using Toujeo which is the relatively new high potency version (U300 insulin) of Lantus so while the spreadsheet indicates does of 4u and 3u, those doses are the equivalent of 12u and 9u respectively.
     
  15. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    I agree with Linda. I was just looking up the strengths for Toujeo and the only one listed is 300 units/ml which as stated is 3 X the normal Lantus strength and is FAR too high a dose for a more recently diagnosed kitty. Your vet does not have a good understanding of feline diabetes.

    With vomiting, nausea, lethargy and refusing to eat these are all things that NEED to be addressed now. Please find another vet to get some testing done and another vet for the ongoing care

    ETA The first thing that needs to be done is to rule out any chance of an infection of some sort, check for ketones and check for pancreatitis. A full blood work with the thyroid test would be in order.
     
  16. Gill & George

    Gill & George Well-Known Member

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    I think that would be the case if she a u100 syringe, if she is dialing the units up on a pen, or using a u300 syringe(I don't think there is such a thing) then units are units, it's just the volume that's different.
    [​IMG]
     
  17. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    Good point it would depend on the type of syringe being used However Toujeo has never been properly tested in kitties and whether the vet has the proper understanding of dosing with Toujeo is unknown. A vet who is not concerned about testing with the symptoms Ham is having and only suggests upping the dose by a WHOLE unit does not appear to have a good handle on FD
     
  18. Amanda & Ham

    Amanda & Ham Member

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    I am not going to give Ham the insulin. I am using the pen so yes one unit is 300 units/ml.

    I am also calling other vets to see where I can get him in.
     
  19. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    Still unsure of the potency of Toujeo compared to regular Lantus. From their website:

    What is Toujeo® (insulin glargine injection) 300 Units/mL?


    Prescription Toujeo® is a long-acting insulin used to control blood sugar in adults with diabetes mellitus.

    • Toujeo® contains 3 times as much insulin in 1 mL as standard insulin (100 Units/mL)
    • Toujeo® is not for use to treat diabetic ketoacidosis
    • Toujeo® should not be used in children
    https://www.toujeo.com/
     
  20. Gill & George

    Gill & George Well-Known Member

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    Exactly Mary Ann, although the info on it says the active ingredient glargine, just like lantus, I've not seen anyone else on the board here using it so we must remain cautious on assuming it will behave in the same way.
    I do wonder about how practical an insulin it is for cats given the difficulties we have measuring the small doses they often end up on when we get to regulation or head OTJ, not to mention the small dose changes we usually make.
    Thank you, for clarifying that you are using the pen needle designed for the Toujeo, so when you measure 1u, it is actually 1u of insulin that he is getting.
    One other question, what is the smallest dose change that you can measure on the toujeo pen needle?
    Good idea on trying to get him into a vet.
    But when we measure out a dose, on any insulin, the syringes/needles are calibrated in units not ml, so the amount of active ingredient is the same, but of course what we don't know about Toujeo is if there is any subtle differences in it's action, which might influence how a cat responds to it.
    I wonder why it's not to be used in kids?
     
  21. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    There were a few discussion on here a while back and it was suggested that it may be useful in members with high dose kitties,


    This is also a concern for me. It may be that the dosing is too strong for smaller children and our kitties are smaller than most children, so I would be worried about that as well.

    Because there is no good data on using Toujeo in kitties I would be extremely hesitant about using this type. Regular Lantus is well tested and documented.
     
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  22. Amanda & Ham

    Amanda & Ham Member

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    Jan 30, 2017
    It only has solid numbers there is no .5
     
  23. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Toujeo is also being marketed as lasting 24 hours and while some humans can use Lantus once daily, the website specifically says the formulation of Toujeo is different. Whether that is just referring to potency or some change to the way in which it is used in the body is anybody's guess but definitely a concern given it is not to be used in children. While I seem to remember seeing something about it currently being tested in cats for use with high dose conditions, Ham has never been tested for any high dose conditions which again suggests to me that the vet is not understanding the difference between Toujeo and Lantus. All the vet saw or understood is that it is glargine.
     
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  24. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I agree with the comments others have made. This insulin is very concentrated so titrating the dose by the tiny increments often needed for kitties is very difficult. I suggest you find a vet who will prescribe regular Lantus insulin to be used with U100 syringes that have half unit markings.
     
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  25. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Amanda is using the Toujeo because her Mom is diabetic and she is getting the insulin from her Mom. The vet did not prescribe the Toujeo...he prescribed glargine aka Lantus.
     
  26. Gill & George

    Gill & George Well-Known Member

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    That might make it difficult going forward.

    But first things first, see what the vet says, and if you are taking him to a new vet perhaps discuss some of the concerns above about Toujeo.
     
  27. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Also make sure the vet understands that Toujeo is u300 glargine three times as potent as Lantus. It may be in your best interests to change insulins if Lantus is out of the question right now. You can order Lantus from Canada at considerably less than it costs you in a pharmacy there but obviously it would take some time to get it so getting a different insulin in the interim might be the best option. I am very concerned that Ham is not feeling well because of the high dose and perhaps the Toujeo itself.
     
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  28. Squalliesmom

    Squalliesmom Well-Known Member

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    Amanda, I have to add my voice to the others here and suggest very strongly that you discuss the use of Toujeo with your vet. I am very concerned that the concentration/amount of insulin that Ham is receiving is way too high for him, which can be very dangerous. I hope your vet can see him ASAP. Please keep us posted, we will worry! :bighug:
     
  29. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    Just a follow up on Toujeo . I found this information on Toujeo .

    "And now, apparently, Toujeo maker Sanofi doesn’t care either, because they just tore up the Unit Rulebook and threw it away. The reason that Toujeo doses 1:1 (meaning you’d take the same number of “units” that you did before) is that Sanofi has re-defined the unit. Toujeo comes only in a special SoloStar pen that actually delivers 1/3 of a unit with each click. In fact, the 450 “unit” pen actually only holds 1.5 mL of fluid, exactly half the volume of the pens we are used to. Basically, the new pen has been recalibrated to deliver smaller doses. For each single “unit” you click into the pen, you’re actually getting one-third of what you are accustomed to but of a higher potency liquid."

    http://www.healthline.com/diabetesmine/ask-dmine-divide-three-carry-one-then-increase-what#2

    So the 3 units of Toujeo, using the Toujeo pen would be equivalent to 3 units of regular lantue. One of the big problems is that you MUST use ONLY the Toujeo pen and can only make dose adjustments of one unit at a time.
     
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  30. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Great find @Tuxedo Mom but that seems a recipe for major confusion for the diabetic community. The information also says:

    "Some oddball things you need to know: Toujeo is so extended that onset of action is not for six hours, and it can take “at least five days” for the insulin-lowering action to “manifest.” Because of this, doctors are advised not to use the typical daily up-titration to adjust the dosage, but to increase every 3-4 days."
    This would suggest re-thinking of protocols here might be necessary if using Toujeo were deemed safe for cats.

    So Ham has been getting the equivalent of 4u AM and 3u PM of Lantus which are still high doses but much more reasonable than I thought.:)
     
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  31. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    My thoughts are that since Toujeo is relatively new and there has been no proper studies done with kitties that it would be venturing into very unknown territory to use this form of insulin. There are no proper comparison with Toujeo and regular Lantus as far as the established protocols go and being a "guinea pig" for how it works with a feline system is a bit too risque for my liking.
     
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  32. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    The interesting part of all this is that the ingredient list is exactly the same for Toujeo and Lantus so why it would titrate differently is a bit of a mystery but I'm guessing it has to be in the way the glargine itself is being formulated which is concerning. The documentation leaves a lot to be desired and leaves lots of room for assumptions that may not hold true.
     
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  33. Squalliesmom

    Squalliesmom Well-Known Member

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    Linda, I agree with you 100%. I think additional research needs to be done before it is approved for use in cats. I'm wary, right off the bat, about using an insulin that says it's not acceptable for use in children.
     
  34. Amanda & Ham

    Amanda & Ham Member

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    I have an appointment with a new vet in an hour... they could not believe my vet recommended insulin knowing Ham I'd not eating. Fingers crossed. Will update after the visit.
     
  35. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Great news and good luck with the new vet. So glad you found a vet who seems to have a better handle on diabetes. Please let us know how it goes! :):bighug:
     
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  36. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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    Happy to hear you found another vet. Please make sure they test for ketones and talk to them about using Toujeo versus Lantus.
     
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  37. Amanda & Ham

    Amanda & Ham Member

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    Ham has no ketones and his fructosamine was 417 and his pancreas was not inflamed so we did not check for pancreatitis. They gave him a shot of anti nausea and a shot of antibiotics. When he go home he did drink some milk. Loozing up.
     
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  38. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Thanks for the update. Glad he's at least taking in a bit of fluids now and hopefully he'll want to eat soon too.
    Did the vet say what kind of infection they suspected? Urinary tract infections are quite common with diabetics due to the sugar in their urine.
     
  39. Amanda & Ham

    Amanda & Ham Member

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    They don't think he has one due to the lack of white blood cells in his urine but just to be on the safe side. And I ask 4 times aboit him being on the toujeo or if we should change it and they said no it was fine, in a week we'd see about changing his dose.
     
  40. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    I'm glad you pushed to make sure the vet understood what insulin you are using but I have to admit I'm still a bit dubious as to the vet being familiar with Toujeo so it still makes nervous. I'm also concerned that if the vet suggests upping the dose by 1/2 unit, you won't be able to do that with the pen and using U100 syringes (there is no such thing as a U300 syringe!) will make accurate dosing darn near impossible. The problem is that quite often, because our kitties are like babies size wise, a very small increase or decrease of insulin dose can make a big difference in their numbers so we usually find changing doses by as little as a 1/4 unit to avoid missing the most effective dose. Not only is drawing up small doses going to be physically problematic but it also carries a significant risk of overdosing.

    Now just so we understand correctly, when you give 4u, do you mean you click the pen 4 times and for 3 units, you click the pen 3 times? I'm asking because I want to be sure we are absolutely clear on how much insulin Ham is getting currently especially since both the insulin and pen you are using are different than what we are use to here. I just want to be sure that if you want or need our assistance in the future, we are all talking the same "language" and not confusing each other.

    I would still strongly recommend you consider getting the regular U100 Lantus going forward. I believe the cost for regular Lantus at Marks Marine Pharmacy in Canada runs about $175 including shipping. You can order the small 3ml vials (SoloStar pens) rather than the 10ml vial. They come in a 5 pack so you are getting 1.5 times as much insulin as you get in the 10ml vial you priced out and because it's packaged in smaller batches, it will last longer than the 10ml vial would. We use syringes to draw up the insulin instead of using the pen so we can make the smaller dose changes. By getting the Solostar pens the insulin based on your current dosing would last you about 7 months for a cost of about $25 per month.
     
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  41. Squalliesmom

    Squalliesmom Well-Known Member

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    We also have a Supply Closet forum here that sometimes has insulins for sale at lower prices, if cost is an issue. Just be cautious as we cannot vouch for each seller there, although some have been used repeatedly and are considered quite reputable. For safety and information's sake please read the yellow "Info" sticky at the top of the forum.
     
  42. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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    I'm very curious to learn more about what kind of a dosing plan your vet intends to use with Toujeo and cats. If you don't mind, please share as you find out what kind of dosing guidelines and parameters he has in mind. The methods we use on the FDMB are all based on a U-100 strength glargine. It's all we're familiar with.
     
  43. Amanda & Ham

    Amanda & Ham Member

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    Yes 4 units is 4 clicks and 3 units is 3 clicks. Yes cost is an issue for me. Like I stated I stressed to the new vet asking if we should change his insulin and she said no keep it the same for now... I'm not sure. I tried diabetic cats in need for help and they didn't help at all :( and I know you all are trying to help but really can't cuz no one is using this insulin... my original vet also said I could use humulin... would that maybe be better
     
  44. Amanda & Ham

    Amanda & Ham Member

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    Jan 30, 2017
    His bg is 321 but he's still not eating
     
  45. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    While Humulin does work for some cats it doesn't last long enough for others. I were in your shoes, I'd stick with what you are using for now and see if there is any Lantus available in the supply closet in the near future. Sometimes people switch to a different insulin, have kitty go into remission etc. and have insulin they are giving away for free or for a very reduced price. We do understand what you are using and while you are the first member to use Toujeo, we can still help you and are quite willing, maybe even excited, to do so. In fact there are probably a number of folks who will be very interested in your experience. We just think small dose changes are going to be a challenge if and when that becomes necessary. :bighug::bighug:
     
  46. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    You are going to have to keep trying to get food into him. Do you have or can you get some plain meat baby food (without any onions or garlic) to try? Is there any "people" food you can offer that he likes? Tuna in water , some poached chicken or even fried chicken. Right now I think finding something to get him to eat is really important even if you have to resort to kibble or high carb food. Sometimes you just have to get them started and they will start eating again. Sometimes it helps to warm up their food so the smell is more enticing.
     
  47. Amanda & Ham

    Amanda & Ham Member

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    It's a no go on kibble. I can run to the store and get baby food and tuna
     
  48. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    If you don't have anything else on hand that he usually likes popping out might be a good idea.
     
  49. Amanda & Ham

    Amanda & Ham Member

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    Ok after 4 trips around the store to find baby food... I got 3 jars and 2 cans of tuna... please kitty eat something
     
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  50. Amanda & Ham

    Amanda & Ham Member

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    Nope still not eating anything
     
  51. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Did you try getting him to lick some off your finger? Do you happen to have a baby syringe around that you could use to get some food into his mouth? If he won't eat tonight, since ketones were clear, I think giving him insulin is a bit dicey although I hate to tell you to skip again. I think the vet should have given you an appetite stimulant as well as giving him the anti-nausea shot and sent some anti-nausea med home with you too. I just wonder if he's feeling punky because of his BG being up. Is he even approaching the dish and sniffing, or licking his lips near the dish? Both are usually a sign of nausea.
     
  52. Amanda & Ham

    Amanda & Ham Member

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    I asked them about an appetite stimulant and they said we're not there yet. No he's not even picking up his head to sniff the plate
     
  53. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Sounds to me like something is going on and the vet has not figured it out. I hate to say it but I think a re-visit to the vet is in order and I would certainly be having a discussion with them about the fact that today's visit was a waste of time and money and expect them to look at him again free of charge. If he's that lethargic and uninterested, something is up.
     
  54. Phoebes (GA)

    Phoebes (GA) Well-Known Member

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    Temptations treats or friskies party mix is what I got phoebe eating after 5 days.
     
  55. Phoebes (GA)

    Phoebes (GA) Well-Known Member

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    He's a beautiful boy Amanda. I hope he eats something for you.
     
  56. Amanda & Ham

    Amanda & Ham Member

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    I just spoke with the vet and they said they did all they could today... and maybe it's the stress of going into the vets office that he doesn't want to eat and watch him over night and if he's not better in the morning call them. Or I could take him to the emergency vet for observation over night which will cost me more money.
     
  57. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Amanda, please look for a Private Message from me in your Inbox
     
  58. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Amanda you know Ham better than anyone else and you know what his behaviour is like now compared to his usual. I don't quite understand how the stress of a vet visit would be suggested as the reason for him not eating since that's why you took him into see the vet today. A cat not eating for 48 hours is in danger of Hepatic lipidosis. A diabetic cat not receiving insulin, not eating, therefore not getting insulin and with a possible infection, is in danger of ketones which can result in DKA. Both hepatic lipidosis and DKA can be life threatening and very expensive to treat.

    If the vet checked for ketones via blood draw rather than a urine test (they will show up in blood work earlier) then DKA is not an immediate danger and Ham has only stopped eating for roughly 24 hours. That said, it would seem waiting till tomorrow morning should be OK however if you think he is off enough to go to the Emergency vet, take him.
     
  59. Amanda & Ham

    Amanda & Ham Member

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    I really can't afford to take him to the emergency vet. I spent more money then I had just to take him to the vet today.
     
  60. Amanda & Ham

    Amanda & Ham Member

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    Jan 30, 2017
    I have been balling my eyes out for hours now cuz there is nothing I can do and nothing is helping
     
  61. Squalliesmom

    Squalliesmom Well-Known Member

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    Amanda, @Chris & China sent you a PM. Have you been able to get back to her yet? She may have information that could definitely be of help to you.
     
  62. Amanda & Ham

    Amanda & Ham Member

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    Yes I have. Thank you
     
  63. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Amanda, I understand how upsetting this is and we will do whatever we can to help. I see Chris sent you a PM and I'm hoping it might have something to do with DCIN. If Ham does need more treatment, they might reconsider if it's a case of him needing vet care. You should see a little red number at the upper right corner of your screen. Click on Inbox to see Chris' message.
     
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  64. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    DCIN is going to be sending her some Lantus, syringes and other supplies
     
  65. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Thank you Chris. Now if Ham will just start eating, they can get back on track. :)
     
  66. Phoebes (GA)

    Phoebes (GA) Well-Known Member

    Joined:
    Jan 16, 2017
    You guys are awesome.
     
  67. Squalliesmom

    Squalliesmom Well-Known Member

    Joined:
    Jun 26, 2015
    Chris to the rescue with DCIN! Thanks Chris! :bighug:
     
  68. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    I'm brand new to DCIN so Amanda is my first "client"

    We'll be learning more about it together!! I knew I'd seen her name somewhere, but had to check with the others to see what the procedures were! Hopefully she'll have her Lantus by Friday
     
  69. Mum of two felines

    Mum of two felines Member

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    Dec 7, 2015
    Do you know if her kitty has started eating?
     
  70. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Chris, I am so glad you came to the rescue. With Ham not eating and the Toujeo Amanda is using, she can't dose anything under 1u. While I hated to tell her to skip insulin tonight, I just didn't feel it would be safe trying even one unit because the Toujeo hasn't been tested on cats and I still wonder if that could be in any way responsible for Ham feeling poorly.
     
  71. Squalliesmom

    Squalliesmom Well-Known Member

    Joined:
    Jun 26, 2015
    no more cry.jpe

    I'm so glad you're getting some help through DCIN, Chris is super-knowledgable about FD, too! Take a deep breath, regroup, and lets get started on getting your boy to eat something.

    Amanda, will Ham eat dry food (kibble) or any kind of treats? At this point it's more important to get him to eat something than to worry about how many carbs it has. He just needs to get some food on board. Here is a recipe for a LIVER SHAKE that is supposed to be very palatable, cats are reported to love it and devour it. Might be worth a try! Sometimes cats who don't seem to want to eat can be encouraged to lick food off your hand, you could try a bit of canned food or baby food on your fingers, see if maybe you can kind of "prime the pump" that way. Sometimes making a slurry of canned food with some warm water will help (it can also be syringed). Bits of baked or boiled chicken breast (no seasonings) is another good thing to try. My cats have always been crazy about baby food ham - that's the only baby food meat they would ever eat. Have you tried that one?
     
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  72. Squalliesmom

    Squalliesmom Well-Known Member

    Joined:
    Jun 26, 2015
    Glad you were on top of it, Chris! :bighug:
     
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  73. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    Amanda & Ham likes this.
  74. Squalliesmom

    Squalliesmom Well-Known Member

    Joined:
    Jun 26, 2015
    Amanda, I don't know where you are located but I remembered reading this post from another member just a few days ago:

    "I am finding these same symptom complaints all over facebook and read an article about a flu in New York with basically the same symptoms that quarantined a feline shelter for a week. For those experiencing unexplained hind leg weakness, it might be worthwhile to look at additional symptoms and start antibiotics:

    The symptoms I have observed include the following:

    • Sudden lost of appetite
    • Sudden disinterest in water leading to dehydration
    • Sudden unexplained weakness with hind leg weakness accompanied by staggering and occasional limb twitching
    • Fever between 103 and 104
    • General body limpness
    • Two of my sick ones had sudden large amounts of vomit at the onset of illness
    • Depression (complete loss of interest in surroundings ie. staring at nothing)
    • Growling when medicating and syringe feeding.
    • No diarrhea"
    Her cat had been experiencing symptoms similar to what you describe Ham as having, just thought you might be interested in looking into it. It may not apply at all in Ham's case, but thought I'd pass on the heads-up just in case. You can follow the entire thread by this member HERE.
     
  75. Milo and Phyllus

    Milo and Phyllus Member

    Joined:
    Aug 11, 2016
    I agree with everyone that says take to vet since I currently have four cats that are displaying similar symptoms with another one relapsed today. All have general weakness especially hind legs. It is some type of cat flu and insulin caused my diabetic cat to hypo when food level decreased. there are complaints all over facebook about a similar illness. Do you mind me asking where you are located? My vet recommended I gather this information in case there is a flu epidemic for our furry friends.
     
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  76. Milo and Phyllus

    Milo and Phyllus Member

    Joined:
    Aug 11, 2016
    this infection whatever it is is baffling a lot of vets. what seemed to help mine most was clavamox and probiotics mixed in the meals along with one dose of prednisone.
     
  77. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    She's in northeastern Ohio
     
  78. Amanda & Ham

    Amanda & Ham Member

    Joined:
    Jan 30, 2017
    He still isn't eating... I have tried wet food, kibble, tuna, baby food, and treats. He did just get up and jump on the counter for some water out of the faucet, used the litter box.
     
  79. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

    Joined:
    May 18, 2016
    Try raising the food containers about 4 to 6 inches. Use a couple of books, or an upside down cookie tin. See if he will eat out of your raise hand.
     
  80. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    If you haven't already tried it, warm the food up a little....it makes it smell more and can sometimes spark their interest
     
  81. Amanda & Ham

    Amanda & Ham Member

    Joined:
    Jan 30, 2017
    I just tried warming it up. This morning when he sniffs it he's locking his lips... I tried to force him to eat some and every little bit I got in his mouth he spit out :banghead:
     
  82. Gill & George

    Gill & George Well-Known Member

    Joined:
    Oct 27, 2015
    I'm sorry you are still having problems with him eating.:bighug::bighug::bighug::bighug:

    This would suggest he is feeling nauseous.

    Raising his food bowl can help as can the anti nausea meds, not sure how long the shot the vet gave him would last, maybe you could get some tablets and give them at home yourself when he needs them. I would phone the surgery and ask about that, tell them he is still not eating. It's been quite a while since he's eaten, I think I would ask them about the appetite stimulants too. Bear in mind that you would want to use both the anti nausea meds and the appie stimulants together, usually folk here give the anti nausea meds, and if kitty is still not eating after a period of time (not sure how long never done this myself) they would give the appie stimulant, you don't really want to stimulate appetite if they are feeling nauseous.

    Did the vet check for ketones?? Did you manage to check yourself? (much cheaper and easier for you to monitor this at home, while Ham is in high numbers)
    You could check at home by getting a urine sample, and getting the ketostix (for humans) at any pharmacy, they shouldn't be expensive, then you'll need to lurk by the litter tray and wait for him to pee, I used a ladle wrapped in tin foil when I needed a sample, I scoot it under BFG's bum to get a sample, didn't seem to bother George though he does give me a funny look:rolleyes:.


    Other than not eating, how is he? Does he appear to be in discomfort? is he meatloafing?

    What antibiotic did they give him a shot of? Why did they give it? Where did they think he had an infection?

    With another missed insulin shot, high numbers, Ham not eating, and possible infection, I am increasingly worried about DKA with Ham, it's not a forgone conclusion, but he has all the 'ingredients' for developing this, and it can come on real quick, try and persist with the vet to try and avoid this becoming an emergency situation for him. I really feel for you as I can see that you have had trouble with the vet.

    Sending Ham lots of feel better soon vines:bighug::bighug::bighug::bighug::bighug::bighug:
     
    Last edited: Feb 8, 2017
  83. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    If he is licking his lips, he's probably still nauseated. I'm glad to hear he drank some water and jumping up on the counter is a good sign. Check to see if he is dehydrated. You can check by pulling up on his scruff and letting go. If the skin snaps back right away, he is well hydrated. If there is a hesitation of the skin returning to position, then he's dehydrated. You can also check him gums? If they are sticky that's another sign he is dehydrated. If he is dehydrated, the vet can give him some SubQ fluids which would help make him feel better.

    When is the last time Ham had a bowel movement? What was the consistency? Formed or loose? More smell than usual? Colour? I presume the vet checked for any hard stool in his bowels so that would hopefully rule out constipation but there are other things that could cause him to feel poorly. I know the vet said his pancreas was not inflamed but low grade pancreatitis might still cause him lack of appetite and nausea. I'd ask the vet to run a SnapfPL test just to be sure.

    When you tried to get food into him were you using a feeding syringe? If not do you have one or can you get one as that's really the only way to assist feed him.
     
  84. Amanda & Ham

    Amanda & Ham Member

    Joined:
    Jan 30, 2017
    Other than not eating, how is he? Does he appear to be in discomfort? is he meatloafing?

    What antibiotic did they give him a shot of? Why did they give it? Where did they think he had an infection?

    Oh my gosh I starter laughing at "meatloafing" although that's what he's doing.

    They gave him convenia. His red blood cells were high in his urine so just as a precaution they gave him that.
     
  85. Amanda & Ham

    Amanda & Ham Member

    Joined:
    Jan 30, 2017
    I tried putting some food on my finger and putting it in his mouth... which he spit most of it out. No I do not have a feeding syringe. His last bowel was probably Monday. I know he didn't have one yesterday and not yet today
     
  86. Amanda & Ham

    Amanda & Ham Member

    Joined:
    Jan 30, 2017
    Should I try some honey or syrup on his gums to maybe entice him to eat.
     
  87. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    http://catinfo.org/convenia-worth-the-risk/
    I'd be suspicious of the Convenia. Cats often have adverse effects that include lethargy, nausea, vomiting. The article I've put in a link for is from a well respected cat vet we often refer to here on FDMB.
     
  88. Gill & George

    Gill & George Well-Known Member

    Joined:
    Oct 27, 2015
    That is often a sign of discomfort/pain, and I have often ' seen' members whose cats suffer from pancreatitis flares, often describe there cat as meatloafing, as well as loosing appetite, and nausea, again I would revisit this with the vet, if he is in pain, some pain meds may go a long way to helping him feel better and start eating some. It's possible that at the early stages of a Pancreatitis flare that the pancreas may not be inflamed enough for your vet to be able to feel it when he palpates.


    That is a possible sign that there is inflammation in the bladder, it is possible that it is infection but again not a forgone conclusion, even if it is infection, from what I have read and understand convenia is perhaps not the best choice of antibiotic for bladder infection. Here's a link to Dr Lisa's site discussing Urinary tract problems http://catinfo.org/feline-urinary-tract-diseases/#Cystitis be it from infection or other. I wonder if you are seeing any other signs that might be indicative of a Urinary Tract problem, she outlines signs/symptoms on her page, might be worth taking a look and see if it rings true.

    The whole Catinfo site has a lot of very useful, practical info/videos that you might find helpful/useful.

    Try not to worry about the Convenia shot, although there are concerns about it's use in some cats, a number of folk here have used it and not had problems.

    :bighug::bighug::bighug::bighug::bighug:
     
  89. Gill & George

    Gill & George Well-Known Member

    Joined:
    Oct 27, 2015
    You could try some icecream perhaps? Or the baby food .... but if honey is his thing and you thing it might get him eating its worth a try.

    How about pees??? still peeing in the litter box?
     
  90. Amanda & Ham

    Amanda & Ham Member

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    Jan 30, 2017
    I would post a photo but I can't figure it out
     
  91. Amanda & Ham

    Amanda & Ham Member

    Joined:
    Jan 30, 2017
    Yes he peed last night
     
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  92. Gill & George

    Gill & George Well-Known Member

    Joined:
    Oct 27, 2015
    I've never been able to post one from my phone:confused:

    But if I have a photo on my pc/labtop I can usually just copy and paste it, for some reason I can't do that of my mobile phone:confused:
     
  93. Amanda & Ham

    Amanda & Ham Member

    Joined:
    Jan 30, 2017
    I think I got it if this works this is how Ham's been all day and night yesterday 20170208_063403.jpg
     
  94. Gill & George

    Gill & George Well-Known Member

    Joined:
    Oct 27, 2015
    I can see him.
    Sounds like he is not moving much and quite lethargic. :(:(
    Poor little kitty.:bighug::bighug::bighug::bighug:

    If you've offered the food and he hasn't taken it up try removing it for a while and then come back to him a little later, perhaps he's overfaced by it all.
    But I think if he is not eating or drinking another call to the vet you took him to yesterday would be a good plan, ask him about the duration of the antinausea etc.

    Do read the info on Dr Lisa's site, it doesn't seem like he is peeing much which in itself is unusual for a diabetic, but if he is not drinking I would wonder if he is dehydrated.
     
  95. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Ham looks like a very ill kitty in your photo. My guy had a bout of DKA and this is how he looked - limp rag doll, no interest in anything. If Ham was my kitty, I'd take him back to the vet ASAP for another evaluation including specific testing for ketones and pancreatitis. :(
     
  96. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    While I don't think the Convenia was the best choice, Ham vomited and stopped eating before the shot so I don't think the Convenia is the problem. It's not the best choice but the vet probably thought it was the best option given the circumstances if she suspected an infection. My cat has had it with no problems so I wouldn't be concerned about it at this point but it is something to think about in the future.

    That's quite the buffet Ham's got there. I agree with Gill. Pick up the food and then try again in a short while. If no luck, call the vet and see if you can get something for nausea and an appetite stimulant and ask about pain med to see if that might help too. He's not curled up in a ball or meatloafing in the pic but if he has been meatloafing abdominal discomfort is still something to consider.

    I'm also wondering if a reduced dose of insulin would help but you can't give anything less than 1 unit with the Toujeo pen and you'd have to be able to monitor him closely and assist feed him if he dropped too low and too much honey or karo might make his nausea worse. The hyperglycemia has to be making him feel punky too!
     
    Kris & Teasel likes this.
  97. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    I might have been overreacting to what Ham looks like in the photo but it reminded me so much of Teasel when he went into DKA.
     
  98. Milo and Phyllus

    Milo and Phyllus Member

    Joined:
    Aug 11, 2016
    Amanda, this is exactly what my cats have been doing when they have been ill this past 2 to 3 weeks. My diabetic cat is still very ill! If your cat is not eating on it's own it is critical that you begin gently and slowly syringe feeding both water and food, Because if kitty doesn't eat for 2 to 3 days straight it will develop other complications and get even sicker. You can feed water and food simultaneously. Even though your baby is attempting to drink water it may not be taking enough in if this is the same virus and will end up dehydrated, which is what happened to mine. More than likely the cat is too weak to help himself to feed or to drink enough and he needs your help to get over the hardest part. I will be happy to provide my feeding technique if you would like me to. Just let me know. Also know that at least 90% of a cat's immune system is in the gut; probiotics will help balance the bacteria and also helps it through the nausea.Two of mine showed very quick rebound after probiotic use.
     
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  99. Squalliesmom

    Squalliesmom Well-Known Member

    Joined:
    Jun 26, 2015
    Amanda, I agree with Kris, I really think you should get your vet to see him again and do some further testing/investigation.
    This is absolutely true. It sounds like Ham has already gone more than a day without eating. I am concerned that he will develop hepatic lipidosis and/or DKA on top of whatever is causing him to be ill in the first place. Please at least give the vet a call and update her and let her know Ham is still not eating.

    For what it's worth, Convenia is not indicated as an effective antibiotic for feline urinary tract issues. It is designed to treat bacterial skin infections, primarily in dogs, and will not help treat urinary problems. I wouldn't worry about it right now, as Ham doesn't appear to be having problems with it, but it is definitely something to research when you get a chance.
     
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  100. Amanda & Ham

    Amanda & Ham Member

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    Jan 30, 2017
    I just tried taking him to the vet they quoted me &150 on the phone but when I got here they handed me an estimate of $ 543.59... I applied for care credit at which I go denied.... now Ham and I are sitting in the crying... I don't know what to do
     
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