? Alice 6/12 home from surgery today / anorexia and PMPS HI.... shoot????

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by AliceMeowliss&Cassandra, Jun 12, 2019.

  1. AliceMeowliss&Cassandra

    AliceMeowliss&Cassandra Well-Known Member

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    She started having a bit of seepage about an hour post surgery. Her stitches on her belly look absolutely gnarly. Her ovaries both had cysts. The belly tumor was removed, she was spayed, and tissue from her belly lump will be sent to be evaluated.

    A huge thanks to DCIN.

    I am SO nervous about taking care of her. She can barely move around right now. I need to cone her. Will she be able to eat or drink with a cone at all?

    She was already bouncing at +11 this morning. She did not have her AM shot at all. Her BGL during surgery time was in the 600s on a feline calibrated machine. I am not fasting her prior to PS testing, just because I want her to eat and drink at all.

    No ketone test but I will as soon as I am able.

    Thoughts on tonight’s shot? I have no doubt her BGL will be fairly high and be a shootable number, but would it be safer to shoot less for any reason? I have an hour before typical shot time.

    Previous post: http://www.felinediabetes.com/FDMB/threads/alice-6-11-amps-132-and-surgery-tomorrow.215554/
     

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    AmandaE likes this.
  2. AmandaE

    AmandaE Well-Known Member

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    Alice looks great, all things considered! You must be so relieved that it’s over! Now you can make room for focusing on her recovery :) You’ll do fine :joyful:

    Looking forward to tomorrow’s update :)
     
  3. AliceMeowliss&Cassandra

    AliceMeowliss&Cassandra Well-Known Member

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    Jan 8, 2019
    She moved and I got a a couple more photos of her belly stitches. .... warning because graphic to some.

    Oh and I got to look at a picture of the ovaries with the cysts on them. I wanted a copy but her phone was wonky.

    I have her lab work from earlier to update later, too.....
     

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  4. LizzieInTexas

    LizzieInTexas Well-Known Member

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  5. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    While she eats, take the cone off of her, otherwise, she won't be able to eat. Then immediately put it back on her.
     
  6. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Poor baby, please keep us posted as to what the biopsy says.
     
  7. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Well-Known Member

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    You might want to see if you can find a onesie that fits her. You just need to cut a hole for her tail but the onesie, if it's not too big will keep her belly covered and prevent her from messing with the stitches.
     
  8. AliceMeowliss&Cassandra

    AliceMeowliss&Cassandra Well-Known Member

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    That would be nice! But it’s just out of the budget unfortunately. Thank you for the link though. Now I will know what to look for in the future. :)
     
  9. AliceMeowliss&Cassandra

    AliceMeowliss&Cassandra Well-Known Member

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    She was 6lbs 7oz after fasting this morning. Is that NB or preemie??

    She is still having some seepage so I will wait a couple of days.
     
  10. Sharon14

    Sharon14 Well-Known Member

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    I’m glad it’s over and she’s home! Feel better quick Alice!!!:bighug:
     
  11. carfurby

    carfurby Well-Known Member

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    She's been through a lot today. I don't think the seepage is anything to worry about right now. It should stop in the next couple of days. As long as she is eating, I think you are safe to give her her normal shot.
     
  12. AliceMeowliss&Cassandra

    AliceMeowliss&Cassandra Well-Known Member

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    Jan 8, 2019
    She has not eaten much so far..... she did want some water, had a small pee. Ketones were either trace or negative. Quite likely negative.
     
  13. AliceMeowliss&Cassandra

    AliceMeowliss&Cassandra Well-Known Member

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    PMPS HI, shot???? Even with only small snacks at best?? I plan to be up often with her through the night.....
     
  14. AliceMeowliss&Cassandra

    AliceMeowliss&Cassandra Well-Known Member

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  15. AliceMeowliss&Cassandra

    AliceMeowliss&Cassandra Well-Known Member

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    Meds: she had onsior already, buprenorphine to start tomorrow as well, along with veraflox.

    She has NO appetite.

    I have mirtazapine and Cerenia. I forgot to get a prescription for ondansetron (Zofran) called in.

    Is it possible she is feeling nauseous???
     
  16. AliceMeowliss&Cassandra

    AliceMeowliss&Cassandra Well-Known Member

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  17. AliceMeowliss&Cassandra

    AliceMeowliss&Cassandra Well-Known Member

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    ....Bueller? Bueller? :p
     
  18. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Hey there, glad she’s home. The anesthesia can knock them for a loop. Do you have any all meat baby food? When Bubba is off his feed I can count on him eating that. Is it possible for you to make a run to the grocery store for a few jars?
     
  19. AliceMeowliss&Cassandra

    AliceMeowliss&Cassandra Well-Known Member

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    I could run to the grocery.... but normally she will eat the Sheba snacks if nothing else. And that’s been a fail. :(

    Just tried to put the cone on her and it is really stressing her out. :(
     
  20. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Try some baby food. All meat chicken or turkey. And grab another test to make sure the Hi wasn’t a wonky test strip. If you have florti flora, sprinkle some on top. Or try a bit of Parmesan cheese. Sounds crazy, but a sprinkle of oregano will sometimes kick start them to eat.
     
  21. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Keep the cone off her to eat. If she eats , put it on afterwards

    I need to sign off 5:30 comes early.
     
  22. AliceMeowliss&Cassandra

    AliceMeowliss&Cassandra Well-Known Member

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    Thanks! Get your rest!
     
  23. AliceMeowliss&Cassandra

    AliceMeowliss&Cassandra Well-Known Member

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    I just don’t know, the HI is definitely accurate as she was 600 on feline calibrated machine earlier and was already bouncing this morning.

    Shoot???? I am an hour late now.
     
  24. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Shoot! You don't want to let ketones get started, especially with her body under extra stress

    Give her the regular dose if she's running "Hi"
     
  25. Olive & Paula

    Olive & Paula Well-Known Member

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    She could be out of it for awhile, she's been through a lot today. Just keep offering food, maybe water it down and try a spoon for her to lick off. Anesthesia could make her nauseous for 24 hrs.
     
  26. AliceMeowliss&Cassandra

    AliceMeowliss&Cassandra Well-Known Member

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    If making her nauseous, would some Cerenia help? (Also would there be any contraindication to its use after anesthesia and pain meds?)
     
  27. AliceMeowliss&Cassandra

    AliceMeowliss&Cassandra Well-Known Member

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    So she received her usual 4u +25.25 from her last shot. (Last night at usual time versus tonight an hour and 15 min late, with AM dose skipped due to surgery.)

    If she will not eat, and considering DKA risk (though so far she is negative for ketones as of 8:30 or so this evening)..... I was wondering if offering a gravy would be worth trying or if that’s the opposite of good? Because so far what I have learned works best for her is to feed her body and keep feeding it and give her what insulin she needs to allow for her to eat...... on the other hand feeding HC just to get her to eat could cause action for how long exactly??????
     
  28. AliceMeowliss&Cassandra

    AliceMeowliss&Cassandra Well-Known Member

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    Jan 8, 2019
    I appreciate everyone for responding. I knew I would be pretty lost once home and yup..... no matter what I tried to understand ahead of time. Gotta remind myself it is a learning experience........ :bighug::coffee:

    So yes. Thank you all. We are grateful.
     
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  29. Cindy&Taco

    Cindy&Taco Member

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    If it's cat food with gravy, maybe you could wash off most of the gravy? That would bring the carbs down some. Just an idea.
     
  30. AliceMeowliss&Cassandra

    AliceMeowliss&Cassandra Well-Known Member

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    With her DKA history, and how weak she is anyway, I am thinking though that she probably really needs it. She finished a full can last night between 9pm-midnight and has barely had much for nibbles since. She normally eats 3 cans a day plus.

    She is water motivated but not food motivated. Does this indicate nausea or help indicate anything else?
     
  31. Cindy&Taco

    Cindy&Taco Member

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    She's most likely thirstier than usual because of the anesthesia and the high BG. She just had a big surgery and is most likely not very hungry. I don't have experience with DKA so that's why I gave you the suggestion for the HC food rinsed off some to get rid of some of those carbs. The HC food will keep her BG high, for how long I don't know. Every cat is different. I hope someone else can answer your questions.
     
  32. Susan&Felix

    Susan&Felix Well-Known Member

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    Oh, CassandraMeowliss:), I'm so glad your girl is home! Sending many vines for her to be comfortable and to get her appetite back soon. (I hope you're more comfortable and are remembering to eat, too.) :bighug::bighug: Does she bother the incision when you're there, or are you able to keep the cone off when you're around? I know it's easier to just leave it on if you're in and out of the room. I'm just thinking she might rest better, and then eat better, if she's coneless and has momma nearby to make her feel safe. But I don't want you sitting up all night on the floor of her room!!

    I'm sorry I don't know about the meds. If she's nauseated, the gravy may not smell good to her; the bland baby food might go down easier. If she's interested in the gravy, though, maybe that'd pique her appetite for her Sheba. They do sometimes get interested in water when they're nauseated, but it could just be that she's rehydrating, and that's a good thing and would likely make her feel less queasy.

    Come on, little Alice, rest well and nibble up some yums for your momma.
     
  33. AliceMeowliss&Cassandra

    AliceMeowliss&Cassandra Well-Known Member

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    @Susan&Felix :bighug: thank you.

    She is okay with the cone off with supervision. She hates it so much she keeps shoving a paw through it. I do plan to spend most of the night with her but I must take a few little breaks. Caved and got takeout even though we can’t afford it because we have to eat. Picking up food and then back to Nurse Cass. :p

    I guess as long as this is generally normal.... it’s a comfort. I’m just so scared she will get bad again. I don’t want to ever go through the level of DKA shock she was in again.....!
     
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  34. Olive & Paula

    Olive & Paula Well-Known Member

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    I don't think cerenia will help if still has anesthia in her system, but not sure. I would give cerenia an hour or 2 before pain med. So it will kick in first. And then when pain med kicks in she feel better. I think she needs to just sleep it off tonight.

    Did they give you any Antibiotics? That was a big surgery.
     
  35. AliceMeowliss&Cassandra

    AliceMeowliss&Cassandra Well-Known Member

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    Jan 8, 2019
    +2 sugar finally coming down a little to a readable number — 456

    Yes Veraflox for antibiotic :)

    So you think Cerenia in the morning before other meds? She will have buprenorphine, and Onsior, plus antibiotic (Veraflox)

    I don’t know what the best schedule between all those meds would be. She’s the first chronically ill and super medicated at all ever cat in my life. She’s my oldest cat. And one of my first two cats (with her brother).

    I am beginning to think she needs to sleep it off too. What are good test times? Will also try food and water each time.

    She wriggled out of the cone but she is too tired to lick and the cone really upset her. I thought I would check in enough to catch her before she has enough energy to even want to try to lick that belly. I think she is way too in pain and out of it and blahhhhhhhh to want to try. It looks like it must hurt quite horribly. :(

    Good idea or no to have my trauma nurse friend come help clean her seepage belly up a bit tomorrow? Fluids are stuck in fur. Friend would be gentle and sterile about it. ......
     
  36. AliceMeowliss&Cassandra

    AliceMeowliss&Cassandra Well-Known Member

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    Can Tegaderm be used to cover wound sites like her crazy stitches? Is this ever a thing? I have used Tegaderm for myself and I loooooved it, and I have had quite a few wound dressings and stitches and staples over the years........

    https://en.m.wikipedia.org/wiki/Tegaderm
     
  37. Crista & Ming

    Crista & Ming Well-Known Member

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    Was she already given pain medication at the vet?

    I'm going to talk about my experience with post surgery patients at work and what we do to give you some insight. It's not recommendations but options and suggestions you could bring up with your vet or if others could chime in to back me up. I'm just not confident in giving solid suggestions:

    The incision definitely looks gnarly. I'd make sure none of the fur is near the incision site. In my experience, after a lumpectomy or spay, we clean the site with warm water, dabbing around it to get the blood out. Bleeding afterwards is normal sometimes.

    Sometimes we do have animals post surgery who are too nauseous to eat, actively drooling, so the vet will administer cerenia IV or SQ hours after surgery.

    Then we give pain meds the same day/hours after the surgery. If you have buprenorphine, you can give it up to every 8 hours.
     
  38. AliceMeowliss&Cassandra

    AliceMeowliss&Cassandra Well-Known Member

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    Thank you for that info. I know to take it as one person’s story! But it all makes sense.

    She had....
    (These notes may have medications grossly misspelt as I jotted them down over the phone prior to surgery)
    “Telazol low dose pre-med
    Gas anesthesia sevoflurane and oxygen
    Shot of ketafin lower dose after lasts 12 hours
    Pain med after: onseior
    Plain oxygen before extubation“

    ETA buprenorphine is supposedly once daily on what I was given and I was only given 3 days of 0.06mL oral doses.
     
  39. AliceMeowliss&Cassandra

    AliceMeowliss&Cassandra Well-Known Member

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    can I give her Cerenia early AM, maybe around +10 or +11? One pain med has to go with food. Should I stagger them all? Veraflox at a different time too?
     
  40. Bron and Sheba

    Bron and Sheba Well-Known Member

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    Cassandra I would give her whatever she will eat. I don’t think it matters if it is high carb at this point. She won’t eat enough to worry about carbs and it is important she starts to eat although poor love probably feels pretty out if it. So if you think she will eat something try it. You are a great mom to her. I’m sure she will feel better tomorrow.
    Sending a plane load of strong Aussie vines.
     
  41. AliceMeowliss&Cassandra

    AliceMeowliss&Cassandra Well-Known Member

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    I was kind of thinking..... avoiding ketoacidosis would be more important than perfect low carbs.
    I have a human diabetic friend who almost died in a car wreck due to low blood sugar. Didn’t know they were diabetic from high numbers or anything. Found out when they wrecked. One or a few high days after this beautiful string of blues and greens will be less likely to cause her harm I feel like than not eating at all......

    That being said I do think it is anesthesia and nausea. I gave her about a quarter of her dose of Cerenia in hopes it will do a little to ease her. She will drink a little and otherwise just sort of lays there. We are all taking a two hour nap then checking to feed and water again and will check sugar as it will be +6. :)

    I’ll take those Aussie vines, strong no doubt!!!! :D

    ETA she hates the cone, had a friend walk me through tying up a cut bit of t-shirt while I nap, to protect stitches. I can’t imagine she would feel up to messing with them for several more hours at least.......
     
  42. carfurby

    carfurby Well-Known Member

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    As long as she is gentle, I think this is okay.
    I wouldn't put anything on the wound without checking with the vet first. I'd check with the vet on whether you can give the pain meds and AB at the same time.

    I hope Alice will feel better today and eat for you. Sending prayers. :bighug::bighug::bighug:
     
  43. Bron and Sheba

    Bron and Sheba Well-Known Member

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    I would not touch the wound with fluids. That is just bringing moisture to the area and could be a pathway for infection to get in. I would leave it myself.
    Human wounds are not fiddled with after surgery.
     
  44. LizzieInTexas

    LizzieInTexas Well-Known Member

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    You will probably get a follow up call from the vet or vet tech today for post-op check.

    Write down all of your questions and ask or, if they have email send the questions to them early so they gave answers when they call.

    I suspect eating will be slow going. See if you can get some Hills a/d. You have to get it from the vet or have him give you an RX and get it from Petsmart that has a vet hospital. It is very high in calories and is for recovering kitties. The data sheet my vet gave me says 7% carbs but others here think it is around 13%. Either way it is very desirable to them. Also ask the vet for a feeding syring. Just.in.case. Trust me, you cannot find one anywhere to purchase.

    The other food you might get is the Tiki mousse. Both a/d and tiki mousse can be watered down to syring if necesary.

    :bighug::bighug:
     
  45. LizzieInTexas

    LizzieInTexas Well-Known Member

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  46. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Well-Known Member

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    I'd avoid tegaderm. A cat as fur. Getting tegaderm off of skin can be a challenge. It could be a mess with a cat even if the area has been shaved.

    There are collars that are less bothersome than a cone. When Gizmo had an abdominal surgery, the vet did not recommend anything for the wound. He really didn't mess with it. It may depend on the cat, though.

    Some cats get nauseated from anesthesia. Others have an appetite. Also, anesthesia slows the GI track so barfing can be an issue.

    Check with your vet about when to give meds and whether you can give the meds all at one time or if they need to be separated.

    You may need to get a probiotic if the antibiotic ends of causing diarrhea. S. boulardi is very helpful with diarrhea but it needs to be separated from when you give the antibiotic.
     
  47. Olive & Paula

    Olive & Paula Well-Known Member

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    You should be able to get 2-4 cans of a/d urgent care food from vet. That should be enough until she starts eating. Just offer small amounts until she is eating. That's my go to when one of mine is really off on food. It mixed well for syringing if needed.

    I still think she is still probably out of it and could be the rest of the day. If she isn't fussing with the stitches now and someone is watching her keep cone off so she is more comfortable. Do you have one of those enclosed play pens to keep her a bit confined but easy to keep an eye on her.

    They will really start to bother her in a few days as the site dries and the swelling goes down pulling on the stitches.

    Once daily pain med isn't enough IMO. Minimum every 12 hrs. I would think for 5 days also. You have a low dose. Try to get more. PJ was given enough for 7 days after her spay but didn't need it after 3.

    Keep trying food, but it's barely 24 hrs since a major surgery, she feels crappy.
     
  48. AliceMeowliss&Cassandra

    AliceMeowliss&Cassandra Well-Known Member

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    Jan 8, 2019
    I got so so so tired so I got her secure and let her rest it out and got up and checked and offered water every couple of hours.... a blur. But she started eating a little this morning. Moving shot back 15 min because she is 1:15 past normal time right now, but that is IF I can shoot.
     
  49. Tracey&Jones (GA)

    Tracey&Jones (GA) Well-Known Member

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    Dec 12, 2016
    Offering no advice just sending a huge hug for you and some heavy duty vines for your kitty.

    :bighug::bighug::bighug::bighug::bighug:
     
  50. AliceMeowliss&Cassandra

    AliceMeowliss&Cassandra Well-Known Member

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    Jan 8, 2019
    @Olive & Paula so you think I should ask vet for additional days of pain meds? Of both kinds? I need to go back there today. My vet is out of office, other vet will remove shunt. Is there any reason to think she might need some additional fluids before it is out?
     
  51. Crista & Ming

    Crista & Ming Well-Known Member

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    I agree with @Olive & Paula. That doesn’t seem enough. Onsior is said to be an anti-inflammatory and pain relief but nothing beats bupe and/or gabapentin.
     
  52. AliceMeowliss&Cassandra

    AliceMeowliss&Cassandra Well-Known Member

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    I am so tired and I can’t nap anymore. :banghead::coffee::coffee::coffee::coffee::coffee:
     
  53. AliceMeowliss&Cassandra

    AliceMeowliss&Cassandra Well-Known Member

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    I really don’t know anything about this stuff. Should I ask for more bupe and if so how much? I haven’t figured out what order to give meds in yet. Checking sugar in 8 min and deciding about shot. Need to start new condo but so tired. Arg.
     
  54. AliceMeowliss&Cassandra

    AliceMeowliss&Cassandra Well-Known Member

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  55. Olive & Paula

    Olive & Paula Well-Known Member

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    I would ask for a supply of bupre If they will give it to you. The other I don't know about. Hopefully they know you will not give if she doesn't need it.

    Cerenia also had anti inflammatory properties, so that should help. Does she have a drain in, or what do you mean by shunt?

    I would give cerenia first, then an hour later the pain med, so that when pain med kicks in, she might be up to eating since cerenia has had time to calm the nausea down.
     

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