? Is she stabilizing or not?

Hi guys,

Julie was diagnosed on Thursday (brought her in for lethargy), and started her insulin on Friday night. She has been started at 1 unit Lantis BID. I have also been giving her sub Q fluids of Lactated Ringer at suggestion of her vet, 100ml BID. She has been refusing to eat so I have been syringe feeding her 3-4 15ml syringe fulls of gruel (high pro wet food mixed with water), mostly Fancy Feast but also have Crave. Have been mixing about 1.5oz of food total maybe? Not measuring exactly. Turkey or chicken flavors, she isn't a fan of seafood. Feeding her largly before her injections, but also giving small meals through day. Today she DID lick some gravy off food offered in bowl, but not much and I still ended up force feeding after some time. She is also getting a 1/4 tab of cerenia 16mg once a day.

She looks better than she did on Thrusday, her coat feels less course/greasy, she is getting up and walking around, she is using the litter box (i've seen her in it at least 5 times through this morning and afternoon).

But she still won't really eat of her own accord. She'll take some licks but that is it. She is usually an eater (I guess why she's in this boat in the first place!). She is not drinking water, but with all the fluids and syringe feeding maybe she doesn't need to. She seems fairly hydrated. I can tell she isn't optimum, but she's not dehydrated. Her gums are pink and moist.

She is still dumpy. She growls but does not fight hard, which she usually does. She seems to have the back leg weakness (going to ask her vet about B12 injections).

I only have a few test strips so I have been testing sparingly. Last night pre injection she was at 190. I read through forums and decided to give her prescribed 1 unit. I gave her 1 unit this morning at about 8 am and then tested her at 1:30pm. She was at 80. I gave her a snack, she licked the gravy a little (Fancy Feast pouch, kind of like a broth). I tested again at 3:10pm and she was at 123.

What I am taking from this is that maybe 1unit is too high? Or is she still adjusting? I have been freaking out that since she isn't eating I need to rush her to vet. I have a budget though. Husband has put a $500 cap on getting through this week. If you all think she sounds OK at this point I will wait to speak to her vet on Tuesday. But if it sounds like I'm just keeping her afloat with food and fluids, please advise! I am more than willing to take her in to ER vet, I jsut want to make my money count. An ER visit is $110. That would put my treatment budget at 400... ya dig?
Thanks guys. Anything is helpful.

 

Hi,

I am glad you are home testing. It is suggested here to never inject insulin without first checking that kitty is high enough for the dose.

Feline Diabetes can take a bit to get kitty regulated. It sounds like your kitty is a little plump, how much does she weigh?

I have to ask with the not eating, is that relatively new? How long has she not been eating on her own? When at the vet, did they indicate any other health issues? Pancreatitis? I ask because pancreatitis is painful and maybe some pain relief is in order. You have cerenia for nausea but do you have an appetite stimulant as well?

One more question - are you using a human meter or a pet calibrated one?

 

Vet declined my request for appetite stimulant. Blood work did NOT indicate pancreatitis. The lack of appetite IS new. Started at least Thursday. I had been sick in bed Tues and Weds so I am unsure if she was down before that. :/ The only other value off on her labs was her lymphocytes, which doc suspected possible lymphoma as well, but I did not have the extra cash that day to send out blood test to confirm. I wanted to get diabetes under control!
She has been plump off and on, lately she had been an OK weight. She was 11.5# in August. At vet on Thurs she was 10.5#. I think I am going to take her to ER tongiht just because if her dose does need to be adjusted, her regular vet wont be open again until Tuesday.

 

She has been about 11-11.5# for the last several years. Before that she was bouncing between that and closer to 13lbs. Dry food diet of Iams Senior and canned once daily prior to diagnosis, now I am only giving wet and have put the dry upstairs (she will not leave the basement).

 

Oh, and I am using an Alpha Trak 2

 

You cannot diagnose lymphoma with a blood test. First up would be an ultrasound.

Are you testing Julie's urine for ketones? With lethargy and inappetance in a newly diagnosed cat, I would be checking frequently for ketones. Speaking of inappetance, would the vet prescribe an anti nausea drug? If she's licking food and walking away, nausea could be a problem. Cerenia or ondansetron are the go to drugs.

 

Ok, that 80 is a safe number! Actually it is a lovely number.

The change in diet can cause a lack in appetite and cause upset. Maybe she needs a slower change over? As well by removing the dry you can drastically change the insulin needs.

 

Tracy: They were eating fancy feast before and she's always liked it and eats it well. I took up the dry on Friday, but did offer some this AM to see if she'd eat it. No go.

Wendy: You can send out blood to test lymphocytes to tell if they are from infection or not. If not from infection, cam indicate lymphoma. She had elevated levels in august as well. You are correct an ultra sound would be next step, but blood can certainly give you info. You can even see mutated cells on blood slides under the microscope if its advanced enough.
I have not checked ketones yet but just ordered strips.
She has been on cerenia since yesterday.

 

We came to er. I debated most of day and decided to get ketones checked and an appetite stimulant as long as levels all look ok. I'll keep you guys posted, waiting on exam room!

 

Ketones you can check at home with Ketostix - usually less than $10 a box of strips. I would push for antinausea drug first. You don't want an appy stim if you are feeling nausea. It could lead to food aversion.

 

Wendy again she has been on anti nausea since yesterday, cerenia. And again, i ordered urine strips just not here till Tuesday.

Vet here at ER thinks she looks pretty good considering. Says I'm doing a good job with feedings and SubQ fluids. I have enough cerenia for 8 days at home, doc here suspects pancreatitis and is sending home buprenex and mirtazapine. Since glucose levels are good and she isn't dehydrated, Dr doesn't think ketones are a concern today. I am to follow up with regular vet Tuesday as planned, or come back here if she worsens before that.

I feel better now. And glad I came to ER. I've had pancreatitis and it sucks. Cant imagine diabetes on top of it! I appreciate you both giving me input! Its hard to not have someone to bounce my fears off of in person. This forum is pretty great.

 

Glad you got a decent report from the ER, or at least an explanation. And meds for the interim. Ondansetron and Cerenia target different nausea receptors, sometimes one works better than the other.

 

I am glad you feel better about her care.

If you would like some cost savings measures for the FD, give a shout out!

 

Update: she lapped some broth on her own just after midnight, and when I got up this morning she was at the top of the basement steps yelling at me for breakfast! She ate about a 1/4 of the amount I offered on her own, I did force feed a bit more just to make sure she got enough in, and I gave her about 75ml sub q fluids. BUT seems brighter today. Pain meds must be helping and the appetite stimulant got her going. I'm hopeful this is the turning point! Call to vet tomorrow afternoon with updates. We'll see!

 

That is a good update! Hope it continues.

 

Glad to hear that Julie's brighter and has started eating a bit under her own steam. Fingers and paws crossed for continued improvement. Really glad the ER vet was able to help you both.

Be sure to keep us posted with Julie's progress!




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