Cat on day three without eating ... waiting for tests to come back

Hello, I have an adorable 13 year old cat, Megatron, who was diagnosed with diabetes in January. He responded really well to insulin, and he was was in a stable place. He's had more energy than he had in years! We've been playing in the morning and at night, and he was jumping up on things, and every time I took him to the vet, he was steadily gaining weight back and his blood sugar was in a sweet spot.

All of a sudden, he took a turn. On Sunday evening, he ate really well, and we played and he was really active! Then on Monday morning, he seemed really lethargic. When I came home on Monday night, he had thrown up all over the house, and had barely eaten anything. He tried eating a little Monday night, and then threw up again. On Tuesday, he didn't throw up, and but he didn't eat anything either. I took him to the vet, and his blood sugar had dropped to 60. The vet couldn't see immediately what was wrong, (he has good teeth, and his heart sounded fine) so he took some blood,and the tests are supposed to be coming back today. I stopped giving Megatron insulin on the vet's instruction last night, and this morning when he didn't eat anything. I've been shooting karo syrup into his mouth. This morning he was acting really strangely, and I hated to leave him to go to work. I've been wringing my hands and reading up about what possibly could be going wrong with him, and getting more and more worried.

Has anybody gone through a similar quick change? I just want my little guy to be okay and happy again.

 

Is the vet testing for ketones? I've been through an episode of diabetic ketoacidosis with my guy and he went downhill really fast when it happened. Make sure you find out about the ketone testing.

 

I'm not sure ... on the invoice it said: Feline Comprehensive Profile. I'll ask them when they call. Thank you.

 

Unless you are giving insulin, there is no need and it is bad to give kero at seeming low BGs.
I would try to syringe feed Megatron now to try to avoid problems. I recommend you join this Yahoo group to get info on syring feeding
https://beta.groups.yahoo.com/neo/groups/Feline-Assisted-Feeding/info

 

Thank you for that. After seeing him, my vet instructed me to syringe feed Mega karo syrup last night and also this morning if he was unchanged.. now I am upset that I possibly hurt him by following the vets instructions? What could go wrong there? I don't know what to do.

 

Is there another vet you can take him to? Maybe an ER vet? Not eating for three days is a veterinary emergency. For a diabetic cat, not eating + no insulin can lead to ketoacidosis (life-threatening), but any cat that doesn't eat for that long is vulnerable to hepatic lipidosis (also life-threatening).

Like Kris, I'm particularly concerned about the possibility of ketoacidosis given the symptoms, and the fact that your vet recommended stopping insulin and also syringing karo after stopping insulin, worries me very much. Not all vets are up on treating feline diabetes-- even some really good vets are not-- and the important thing now is to get Megatron the care he needs.

Hopefully the test results will be in soon, with an answer on ketones. If the results don't come in or your vet didn't do that test, I would take Mega to a different vet ASAP.

 

Thanks so much. I ran him back to the vet, and they said it might possibly be a urinary tract infection, and they gave him some fluids and antibiotics and anti-nausea stuff. They're testing his blood for pancreatitis, and I went to the animal hospital to pick up the emergency diet food you feed with a syringe. I'm so glad I didn't drop him off at home before heading to the animal hospital, because they took him in so they can get a urine sample to test for ketones. I'll know more tonight. Hopefully, my little guy will be okay.

Thanks for your help.

 

Ok LOVE THE NAME!! Good luck with your furbaby!!

 

Please keep us posted!!!

 

I hope your kitty will feel better soon. I recommend that you buy some urine ketone test strips at a human pharmacy and start testing Megatron at home. It sounds harder than it is. Here are some methods to try:

• put the testing end of the strip directly in the urine stream when he's peeing
• slide a shallow, long handled spoon under his backside to catch a few drops of pee - doesn't take much
• cover his favourite area of the litter box with a few layers of plastic wrap and push some depressions into it to catch pee.

Check the strip instructions. You need to let the colour develop exactly 15 seconds for many of them. View the colour in really good light.

Testing urine ketones frequently will give you a warning if they're starting to develop. That way you can get vet advice ASAP.

 

This is great advice, thanks Kris!

The test this afternoon came back negative for ketones! So we're still waiting on the pancreatic test and the other urinary tests. When I cam home from the hospital, he dove right into the a/d cat food the hospital recommended, and I was also spoon feeding him beef in beef broth baby food, which he loved! He didn't eat a whole lot so far, but it was much better than the past few days. And so far he hasn't puked. I called the hospital after he ate, and they recommended I hold off on the insulin for tonight and check again tomorrow morning. It's been a pretty exhausting and stressful couple of of days so I'm hoping we feel better soon, too. Thank you!

 

Whoo hooo!!!!! That is fantastic news!!!!! Soooooo glad he's eating again!

 

Yay for no ketones, no puke and an improved appy!

 

No ketones! That's wonderful! I still think ketone testing at home is a good safety measure.

 

Thanks everyone for your encouragement! It's really appreciated! I'm still a bit vexed. Mega has been eating a little, but it's not nearly as much as he should be eating, and he didn't seem interested in food at all this morning until I started spoon feeding him, or lifting up the bowl to his cute little face, and he's super lethargic. The hospital vet said there's no sign of infection or anything in his urine. She gave him a mirtazapine today. Still waiting on the pancreatitis test, but since it wasn't ketones or an infection, or anything else in his blood work, what else could be making a diabetic cat who had was doing very well take such a downward turn? Is there anything else I should be asking the vet about when I see her tomorrow? He barely even fought me when I was getting him to his carrier today, which is not like Megatron at all.

 

Pancreatitis can do that, Jones was just in an awful state before we could get it under control. Did she check kidney and liver values as well?

Is he in pain by chance? If so, I would see maybe about getting something for that.

 

Have you restarted insulin or still holding off? I would normally start off with this but you had a specific situation first so I thought I would wait. Can you setup your signature with some information? http://www.felinediabetes.com/FDMB/threads/editing-your-signature-profile-and-preferences.130340/

Are you home testing?

And this is good to have, hoping you won't need it again: http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

 

Just so you know: some cats have a strange reaction to mirtazapine - yowling, agitation, etc.

 

Are you giving insulin now? If so, I would strongly urge hometesting if you aren't already doing it-- his lethargy may have nothing to do with his glucose levels, but that's the first place to start looking. And going forward, hometesting is an incredibly powerful tool for managing feline diabetes. It's also the best way to keep him safe when giving insulin, especially over the long term-- cat's insulin needs can change over time, as you discovered.

I agree, pancreatitis is a possibility, and that if that's what is going on, some pain meds might be helpful. I think you said your vet was going to test for that-- have the results come in? Any other symptoms besides lethargy? How are his litter box habits? Strange as it sounds, a bad bout of constipation can wreak havoc on a cat's whole system-- they feel awful, nauseated, don't want to eat, etc.-- and it can mimic a number of other health issues, so it's something to consider.

Glad he's eating a little bit-- much better than when they go on strike completely, it gives you something to work with (maybe there's some very tempting treat that can get him to dig in more. Here are some tips on things some cats find irresistible). And the ketones negative is a huge relief. I just hope they can figure out what is going on soon, so he can start feeling better!

 

Thanks all, signature added!

I've been holding off on insulin for now, until we go back tomorrow (or if his eating habits pick up, whichever comes first!) I haven't been homestesting, but after looking around here, I should totally start.

The pancreatitis results aren't in yet, so we'll see ... He doesn't seem like he's in pain, he's just very lethargic, but still very purr-y and responsive. He's been peeing less than usual, and he pooed this morning, but it wasn't up to his normal standards. Maybe it is constipation. Poor guy!

 

I really hope you decide to home test. It has saved many a kitty's life here . It is possible his lethargy is from BG bouncing in higher numbers after the hypo. If you were home testing you could find out .

 

My vet told me it was an anti-depressant drug. So Kitty basically runs on a high - which makes for the yowling and hyper state - and then the munchies. It was not actually developed as an appetite stimulant it was more of an accidental find.

I was pretty amazed by that.

 

If he needs an appy stimulant ask your vet about cyproheptadine, it doesn't have the nasty side effects that can accompany mirtazapine.

 

That's really interesting, Tracy! That explains some of the behavior I saw from Mega when I got home.
Also! I home tested for the first time! Thanks for the encouragement & the resources! It's not so tough. Now I'll have to be fancy and make a chart like everyone else. His bg was at 168, and the hospital said to hold off on insulin for now. He seems interested in food, but isn't eating or drinking much. Trying some of the appy stimulate tricks ya'll suggested, though! Poor guy also has loose stool, but he's going in the liter box, so that's a positive! Going back to the hospital again tomorrow, so I'll hopefully we'll figure out

 

They can purr to self soothe, not always happy and content. Is he sitting in meatloaf position head down? Stiff or arched back when he walks? Nausea is huge in pancreatitis kitties, if it comes back positive. Hope your furbaby is feeling better soon.

 

You don't even have to make the fancy spreadsheet. We have one already done for you, you just have to link it up!

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

 

Sweet! Thanks, Djamila! You all are the best! I know, Phoebes, it's so hard to tell when they're in pain! My guy is missing half of his back foot (since I picked him out from the shelter as a kitten! I think he was born that way), so it's hard to tell what's happening from his walk, sometimes. I've been looking out for the meatloaf position as a key to what's going on. We'll see what the vet says tonight, but he seems to be getting better, little by little.

 

keeping my fingers crossed for the rest of the test results. For poor appetite depending on the reason either something stinky or warm chicken might help. x

 

I see you have your spreadsheet set up with one number (a good one!) in it but no dose info in the "U" column for AM and PM. It would be very helpful if you could fill it in when you have a minute.

 

Just got back from hospital vet. He's negative for pancreatitis, still no ketones, his BG was 179, and his blood work all looks normal. He's acting more & more like himself and eating on his own without any extra encouragement! We're going to see how he goes once the mirtazapine is out of his system on Sunday, and I'm going back on Monday to make sure everything is still okay. The only other thing the vet can think of doing is x-rays. She thinks he bottomed out from the insulin on Monday/Tuesday, and that he doesn't need it anymore. She said she's only seen that happen to one other cat, but that it can happen. He looks so cute & happy right now. Thanks for all your support & everything! I'll continue home monitoring to make sure he's okay.

 

There has been mention of cats "hypo-ing" into remission . He is still slightly above normal BG range (50-120 human meter; 68 - 150 pet meter) compared to a civvie cat so definitely continue to monitor. I would suggest AMPS and PMPS *paws crossed* He might still need a very tiny dose to get him there, but let's see .
Glad to hear everything else checks out so far

 

So glad every thing is ok so far. Hope he goes into remission fur you!!! Crossing everything. Head bumps keep it up Megatron. (Never thought I'd say that in my life time)

 

any update? Hope he's doing well x

 

Thanks for checking in, SweetAngel. Megatron's doing great! We're still getting used to the BG testing thing, sometimes it works, sometimes it doesn't. I've watched a few videos and we're getting a hang of it, and the numbers I'm getting look good. He's getting more and more playful and active and more like himself every day. We couldn't be happier. I thought I was going to lose him!

 

that's great news. Fingers crossed he goes into remission soon xxx

 

dreakb- My kitty Leo had a similar thing happen. He was only on insulin a couple weeks when all of a sudden he went down to 60 (pet meter) and got very lethargic and didn't feel like eating. This was before I was regularly starting to test him and was still giving him insulin. It was scary so this is when I started testing daily (or trying to anyway) and found that his glucose was staying within normal ranges every day. I wasn't expecting that to happen so quickly and I suppose he could go back to diabetic levels again at some point. Maybe this is what's happening to your kitty? Leo's specialist called it transient diabetes.