911 DeNiro Hypo Again

DeNiro had a hypo incident about 2 weeks ago and has been off the insulin since with good readings between 4.2-5.4 all that time (76-97 USA numbers). He developed an abcess tooth last week and is on clavulox 2 times a day and a painkiler once a day. The goal was to get the infection under control and get some weight on him before surgery...he is so thin the surgery is a real risk. He hasn't eaten much today and I just tested him and he's 2.5 (45 USA numbers). I thought it must be wrong so tested him twice, then tested myself and the number is right. I've given him some honey. When can I test again to see if the numbers are going up? What could be causing this? Poor DeNiro. I'm so worried I'm going to lose him. Can't get weight on and he's gone from diabetic, to hypo without insulin. Argh. Advice would be so appreciated.

 

If a normal (non-diabetic) cat's BG numbers are between 50 to 120, then the 45 could just be because he hasn't eaten.
When you do get he dental done, I would suggest going to a Dental Specialist, if you can afford one.
The antibiotics often make a cat inappetant. Have you been giving him some probiotics to replace the good bacteria back in, after the ABs take all the bacteria out? I've use FortiFlora as a probiotic when J.D. is on ABs and almost always have to give an appetite stimulant to get him to eat when on ABs.
How old is DeNiro?

 

Thanks so much for your reply. Very hard to know DeNiro's age. I rescued him from the pound late last year, some vets think he's old, others think maybe about 2. He's very beat up looking from being on the street, so very hard to know. I will try to find him a probiotic tomorrow. Those sorts of things are so much easier to find in other countries. Anyone have any suggestions where I can find one in Australia? Any ideas how I can get some weight on him? He's been thin since I've had him and it's a catch 22 with the teeth...they're probably causing it but without getting weight on the surgery is apparently very risky. Re dental specialist, I could go that route, though I do really like and trust my own vets who seem to really love and care for DeNiro so a bit torn on that decision?

 

I took J.D. to a Dental Specialist because his regular vets wouldn't do a dental on him because he's 18. I had a cardiologist do an exam on him first with an echocardiogram just before the surgery, and I had a dedicated anestheseologist during the surgery (sorry for any spelling errors).
When J.D. came home from this last dental in January, he had had a very badly abcessed tooth extracted along with some others, and he had to be on Clindamycin which is a super strong AB for 2 weeks. After a day or two he was throwing up from the ABs and I thought he was having diarrhea, so I called the vet and they told me I could stop the AB. I said, but I thought you said he had to have these ABs because of the extent of the deep abcess. I ended up continuing the ABs as long as the two weeks because I felt he needed it and I went to a Health Food Store and bought an extra strength probiotic Ultimate Flora Critical Care 50 Billion. It's always been tough for me when my cat is on ABs trying to get him to eat and to help his tummy feel better.
Your vet doesn't think you're going to put weight on DeNiro while he's on Clavamox, does he? You might want to explain the inappetance, and ask for an appetite stimulant like cyproheptadine to go along with it.

 

I will often give J.D. baby food (meat and broth only) when his tummy is upset. It's not nutritionally complete for a cat, but if DeNiro will eat it, it could help to give his tummy the feeling of being full again, and hopefully when his tummy empties he'll be hungry enough to eat some regular cat food.

 

Thanks so much for the advice. DeNiro's regular vet is off on a week's holiday....but the practise is great and will hopefully prescribe an appetite stimulant over the phone...I will ring them in morning and ask. It's DeNiro's frail appearance that worries them re surgery...he is skin and bones, but now with his bg numbers so low, perhaps i can feed him more fattening food with gravies etc provided i still monitor him regularly and make sure the numbers aren't going high? When I rescued him the pound had him labelled as feral and refused to microchip him (which has to be done according to law here) so they sent him to a vet to be given anaesthesia for chipping...I told them to desex at same time. When i collected him they said they tried to remove a tooth...I wasn't happy with them at all....not sure what they meant by "tried" but vet says one of canines cracked off, can't see any of it, but root still there. I suspect that's what's caused his weight loss. Also, on examination vet thinks kidneys feel big, but last blood tests showed kidneys were ok...she thinks they might just feel that way cause he's so skinny. I think it's all a catch22...he won't get better til the teeth are done, but it's risky getting the teeth done because of his condition. I so want him to feel better.

 

It's getting late Sunday night here and I have to work in the morning but will get him the baby food you suggested tomorrow...also thinking of getting a high cal vet food and syringing food into him...will be upsetting for him to have that happen, but he needs food! I've just given him some more honey and am going to head off to sleep and get up early and test him again. So sad for DeNiro...was so happy when he went into remission, now he's getting low numbers and is fighting this awful infection and not eating enough. I just want him to have a great healthy life and want it to start asap for him.

 

That's one of the reasons I went to a Dental Specialist, because some vets may be set in their ways and only used to using a few different anesthetics (I'm not so good with medical terminology ), and the Dental Specialist and anesthesiologist have a whole bunch of combinations they use and fit the right one for your particuliar cat.
With possible kidney issues, I think you want him to get fluids before and during and maybe after the procedure.
I researched this all last December for the January dental, so my memory is a bit faded.
They should keep DeNiro warm during the surgery and as he wakes up. I would want them to use the least amount of anesthetic as they comfortably can, and use something that they can wake him up instantly should there be a problem. You want his temperature, and blood pressure monitored the entire time.
J.D.'s abcess was a canine, too. It went really deep up into the top of his mouth.
That root has to come out of there. Is it an upper or lower canine? Maybe the baby food or some well blended (to the consistancy of a milkshake) regular food will be easier for him to eat with a hurt mouth. I would be careful with the higher carb foods. Do like you said, and monitor his BGs if you give him the gravy foods. He might just lick the gravy and that's were most of the carbs are.

 

Thats great that deniro is OTJ!

I would be very careful about the gravy foods though - you dont want to lose that precious remission!.

First you could try giving him 1/4 tsp of coconut oil (organic cold pressed) every day to see if that brings his weight up -
Also look at this chart and see if you can find a food thats less than 10% calories from carbs (column C) but is higher calorie than what you are feeding now. Plus feed him more if he will eat it. http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf

Some cats sit from 40-130 so that number is ok. And he cant hypo really (except in exceptional circumstances) when he isnt getting insulin. As dyana said, the antibiotics are probably upsetting his stomach.

Make sure they give you post surgery pain meds to take home.

Wendy

 

You can also give additional protein, up to 15-20% of the daily food intake. Something like chicken, or turkey. Cook without spices of any kind, cut up into tiny pieces, and add that to his diet.

Some kitten foods have higher calories. You might try those to fatten DeNiro up.

Your vet may know of a Max calorie food. Iams makes something like that in the States. Not sure on the carb content though.

The low numbers are not a hypo per se. Not at least without insulin. They are simply low numbers. One of my civies regularly tests in the 40's (2.22 mmol/L). Some cats without insulin test in the 30's. ECID.

 

Not sure what part of Australia you are in, but I googled vet dental specialist australia and here is what popped up:

http://www.animaldental.com.au/

http://www.ava.com.au/about-us/who-does ... t-groups-6

http://avdc-dms.org/dms/list/diplomates ... N=27739357


David E. Clarke
Diplomate
Hallam Veterinary Clinic
81 Belgrave-Hallam Road
Hallam, Victoria 3803
Australia
011-613 8786 3970


Stephen V. Coles
Diplomate
Sandringham Veterinary Hospital
262 Bluff Road
Sandringham 3191
Australia
011-61-39-598-3621


Nadine Fiani
Diplomate
Small Animal Specialis Hospital (SASH)
Level 1, 1 Richardson Place
North Ryde , New Soth Wales 2113
Australia
011 612 9889 0289


http://dir.yahoo.com/business_and_econo ... +australia

you will need to search this directory for dental specialists