Cat not eating? Came home from a week at er last night. help?

Hi. So my newly diagnosed diabetic cat Morton came home last night from a week in the ER with DKA, sepsis, pancreatitis and severe electrolyte deficiencies and potassium. He was on a feeding tube too. Still very skinny. I was supposed to give him his 0.5 unit of lantus last night but had to skip because he isnt wanting much food. He had some diarrhea dripping out of his butt all night though and on my bed where he wanted to cuddle ALL night so that is messy now. I'm wondering if he doesnt want food because of the diarrhea. I gave some cerenia last night.
Medications: clavamox which he HATES. 0.6mls twice a day. my vet tech friend said it can make cats feel yucky..take with food but doesnt want it
Metronidazole 0.8mls twice a day
Potassium pills
Enrofloxacin 1/2 pill daily. With food but he doesnt want foo .
Mertazapine on ear for appetite.

Hes going in to the vet (my work not the ER) to get a BG. I suggest if it's high then to do his normal dose of lantus? The specialist just wants it once per day.. and to get samples of DM cat food.

His whole issue is ever since I got him at 4 weeks as a foster he has been so hard to feed. He is so picky it's ridiculous. I've tried everything in the books even microwaving but it comes down to him just wanting his regular kibble when he feels like it. I'm really hoping it's just the antibiotics causing his lack of appetite and the diarrhea kind of oozing because the oozing never used to happen..

He was on atopica to control his ITP and that made him anorexic and started all of this and he cant be on it anymore so I figured his appetite would be back but right now it's not. Not gonna lie I need some support here..him not eating enough and needing insulin is seriously stressing me out

 

Alicia: with the DKA in the picture, let him eat anything he wants (within limits imposed by his other health issues). Don't worry about low-carb for now. You're right that antibiotics can make them feel yucky, so you're probably fighting against that a bit.

 

Adding: we can help you learn to test BG at home so he doesn't have to keep going back to the vet. It's much easier, cheaper, and the best way to keep him safe. After a DKA, he does need insulin to help prevent the ketones coming back, if you can monitor the BG at home it will be much less stressful for you to administer it.

 

The thing is he turns his head to anything. Even his favorite meat tubes. Baby food smelling made him gag. I'm just stressed. He usually doesnt want food when he has diarrhea now that diabetes is in the pic I feel like I'm losing this battle

 

I am surprised that (from the info provided) they took out the feeding tube. Is Morten amenable to being surange fed? I have syringe fed many cats and now one civi gets about 1/2 her calories from syringe feeding.

 

They said he was eating well on his own. The meds they send home might not have been the same as he was getting there. I know clavamox is notorious for causing upset stomachs and he has never really had diarrhea oozing before so I think it may be that.. his bg was 180 today and I came home with my ketone test strips and glucometer. Poor thing just really doesnt want his bg checked he hates it! My tech friend did it for me today. They said to give him his 0.5 unit after he decides to eat a meal so whatever time that would be at.. I also made myself samples of the glycobalnce and DM food I doint he will want but just to try. And I got him some name brand tumil k tahe since the generic ones are disk shaped and so hard to get down him! He seems very comfortable though and very tired he slept on me literally all night and I didnt sleep because he was twitching wo hard in his sleep probably just sheer exhaustion

 

Please call your vet and explain the different meds situation and the lack of eating.

 

I agree-- maybe the vet can switch up the clavamox with something else, if indeed that's the main reason he's not wanting to eat right now? Or they might have some other suggestions.

I'm glad he snuggled with you all night. You're right, he's probably exhausted, and so happy to be home...

 

I called the receptionist and she left a message for the doctor. I couldnt see anything else that could be causing his diarrhea.... hes been on metronidazole before FOR diarrhea so it's not that. My tech said clavamox usually makes cats sick so she is betting on that but said to call the hospital and ask what can be done

 

So I called the 24 hr care place and his specialist said discontinue the clavamox because he really doesn't think the metronidazole and the floxacin antibiotics would be causing it. said give him a bland diet but him not eating it doesn't matter the diet since...he won't eat lol. So he got his 0.6 mls this morning and that's the last of the clavamox he will be getting. I really hope this helps

 

Crossing fingers that he'll be feeling like eating soon!

 

That makes me wonder if the poor guy is nauseated. Is he licking his lips at all?
Giving mirtazapine to a cat that is nauseated is not going to work....it will just make him miserable. I'd ask the vet about something for nausea like Cerenia and/or Odansetron.

 

Clavamox definitely makes several of my cats feel just awful. And I second the recommendation for Ondansetron, it is doing wonders for our 18 year old when Cerenia wasn't doing anything for her.

Hill 's A/D wet food is good because it is high calorie, and because it is very smooth to syringe feed. If you can have Ondansetron on board for nausea, Mirtaz on board for appetite, and just syringe feed a little bit, getting that little bit in their stomach makes them feel so much better and they'll then start to eat on their own. Also...FLUIDS! Can you do fluids at home or get your tech friend to help? If no heart condition or anything else that contraindicates it, I find it just makes them feel so much better, and then they are more likely to eat.

Deli ham or Turkey is often a winner for me, others suggest parmesan cheese sprinkled on food but that never worked for us. Is there any people food that he ever loves to get a tiny bit of? If so, now is the time to capitalize on it.

Here's a list that I am blatantly plagiarizing from @Susan&Felix (thx!) that seems to cover most of the suggestions I've seen:

-making a buffet to give him choices
- heating food

sprinkle food with :
- forta flora -- a probiotic you can get at vets or online. is very smelly and cats love the taste of it.
- parmesan cheese
- smashed crumbles of dry food
- bonito tuna flakes
- halo chicken treats -- crumble into dust over food
- pour a little water from tuna in water over food ( I use low sodium/no sodium added as other kinds in water has veg. broth in it and I assume that means onions, which are toxic to cats-- check labels)
-powdered oregano. yep sounds weird . but some cats like it and it will entice them to eat.

other ideas of foods to offer your kitty to stim appy:
- trader joe tuna for cats
-baby food -- beechnut turkey and broth or chicken and broth. they have no onions or other additives. some babyfoods have onions . please read labels if you can't find beechnut.
- kentucky fried chicken
- deli turkey /chicken
- plain cooked ( boiled or baked ) chicken breast
-canned chicken for people (watch the label that their are no onions)
- chicken broth -- low sodium

 

I hope Morton starts to feel better soon

 

Thanks for the replies. And the lengthy one about food. I am well aware how to feed a cat that isnt eating (no offense!) He just literally will NOT eat. Force feeding sounds terrible because unlike last time he is very nauseous. Smelling anything wet and not dry he gags! Cerenia seemed to not really work and I have been giving Odansetron since last night it seems to be a tiny bit better for him but he only really Ave a tablespoon of his dry. The specialist recommended an ngn tube? He had a tube there it was through the nose...can they feel that? They think it would be best.. is this common for a cat that went through dka, sepsis and pancreatitis to need a feeding tube again when bringing home? I am confident he will eat again but the diarrhea he has HAS to be from either the clavamox I stopped or from another antibiotic. He has about 5 more days of them and I really cannot wait this out the poor thing is so hungry

 

No offense taken -- we never know what the level of knowledge is of people stopping by here, so better too much than not enough. And I have a few cats that eat like little birds too (fortunately they are not the ones that I NEED to eat regularly, like my diabetic or my CKD cat), and I know how frustrating that can be.

You are right, if the nausea is a problem then it is going to be a battle. If it helps you conceptually, it is technically called "assist feeding", and often you just have to get them started, and the little bit of food (absent nausea) will actually settle their stomach and get them eating. I hope you get some relief with the Ondansetron. @Larry and Kitties even does assist feeding long term on one of his babies.

I can't answer about how the NG tube feels, but it is certainly an easier way of getting a tube in. Did Morton have an E-tube in the hospital (placed directly into his esophagus through a hole around his neck)? I had asked if he was coming home with it still in, because it seemed foolish of them to remove it prematurely if it was already there. They usually aren't removed until a cat is eating and drinking sufficiently on their own, and it sounds like Morton was still not even though we hoped he would do better at home.

@AliceMeowliss&Cassandra , did Alice come home with a feeding tube, and if so which kind and how long did it stay in? Or same question to anyone else that has been in that situation.

 

He had the tube through his nose.. which is the one they will use again. His whole neck is shaved but he had a central line in since he needed iv meds and blood work every 2 hours they also put the blood back into him that way so he wouldnt become anemic. His specialist recommended the nasogastric one to be put in today since it didnt require sedation and he handled it well. They did say he was eating a little on his own there so they removed it. Kind of stupid choice in my opinion. He is missing the litter box and dribbling diarrhea on the floor so clearly he isn't feeling well and the gagging I've never seen him do so it has to be severe nausea even with the nausea meds

 

So his vet said he actually looks remarkable and his labs are amazing. He isn't diabetic right now either (cats are sooo frustrating lol) but they are putting an e feeding tube in she said its more comfortable for them vs the nasal one he had while he was staying. They just want to keep him over night just to monitor and said I can give I'll his meds through the tube and thankfully it will be more comfortable for him. I'm still stressed. But this is the best news in a while. His liver is a little funky right now but she thinks because he's been basically starving himself. Prayers for little Morton please

 

If he just wants his kibble just hive him that. I've had to do that with Simba. Just read the content of carbohydrates on it, and adjust the insulin there after.
When I first tried to change Simba to the low carb 15 % wet Med, it's contet was liver. And Simba hated liver, the yuckiest thing ever he could think off. So of course he refused to eat that. So I let him have his low carb dry food and just adjusted his insuline does after that to, in Simba's case 1 1/2 insulin dose evening and morning.
Every cat is different so that was what worked for Simba.
And I don't blame Simba, even I think liver both smell yucky and is the yuckiest ever.

Veterinarian Dr Lisa Pierson, who have been present here before in person, worked out a raw food recipy many cats like. I tried to make that for Simba and Gustav, but it contained the ingredent liver, and while Simba left the kitchen from that awful smell, I myself nearly throw up from handleing that liver. I however read up and exchange the liver to egg yolks containing basically the same vitamins, proteins e.t.c, and that Simba and Gustav liked better.

I also used KMR cat rescue and recovery milk when they were sick and wouldn't eat and mixed it with an egg yolk and syringe fed them. It says on the KMR package how much KMR they should have a day in serving.

Hope you find something, meanwhile let him have a little kibble, any food is better that none at this stage and calculate from the kibble carbohydrate a bit higher dose insulin so it matches the higher carb content.

 

I'm so glad he'll be getting the E-tube. I've never had a cat with one myself, but I've heard several people around here credit them with saving their cat's life. Definitely much less stressful for you, too!

Also glad his numbers look good overall-- just have to get some food into him to turn the liver around. Come on, Morton, you can do it!

As an aside, this cracked me up:

Simba is not fooling around-- no liver!

 

He LOVED primal freeze dried food but my vet said absolutely no raw food because of the bacteria and since he already gets so many random infections. It's a real shame because when he was sick months ago it's all he wanted..

This little boy has cost me probably 11k since I purposely foster failed him over a year ago

 

Prayers for sweet Morton

 

Here is veterinarian Dr. Lisa Pierson's own page with tons of information.
https://catinfo.org/

I am so grateful for her, because in the beginning of Simba's diabetes here were I live there was a vet in charge of him that did Simba so wrong with the food, and put Simba on Acarbose as if that would help when changing his food to low carb was what was needed to do, and I came here and Dr. Lisa Pierson immideatly stepped in and stopped the Acarbose and I got help for the low-carb food instead.
Try gulp read up so much info you can on Dr. Lisa Pierson's own page. She has been an Angel and helped so many and I am sure she will be born as an Cat Angel next time too.

Come one lil Baby Morton, your mama is doing everything she can to help to better health, so help her help you. Even sit in mama's lap and help her read it when she reads Dr. Lisa's page.
https://catinfo.org/

 

Sending purrayers for Morton! Sounds like he's on the right track. I've given food and meds through a nasogastric tube before, but it sounds like the e-tube will be better. Could you microwave/cook the raw food, or would that ruin it for him?

Thank you, but I can't take credit for it--I lifted that list, which I've seen elsewhere around the board.

 

So he couldnt get the tube because they found his platelets to be 68,000. On monday the were in the 700,000s. He was sedated and they woke him up and he started eating a lot. I ordered canna pet CBD pills for small animals and I'm hoping to try it tomorrow or Saturday for him. It cant hurt. But he has to go on something for his ITP... and manage the diabetes. I'm so stressed and OF COURSE his ITP specialist went on a 2 week vacation today. I knew his platelets would go down quick i was just waiting for this to happen

 

Glad he is eating. Hoping he continues to eat and it is not a one-off.

If I remember correctly, initially he was on pred for his platelet count. Has pred been banned as well as cyclosporine?

Your best bet is to call the ITP specialist. There should be a message on the answering machine about what to do in case of an emergency. Hopefully, it is a referral to another specialist on call.

 

He's seeing an internal medicine specialist tomorrow morning luckily this place has literally any specialist you can think of and most specialize in and love cats. The tech said he is in great hands and stay positive. Hes not diabetic at this time and looks great just his stupid itp that will probably be a life long thing. Instantly it seems he loses all of them but thankfully instantly within days his platelets go back up with suppression

 

We are rooting for you baby Morton. Keep the spirit up and keep fighting lil man.

 

just a quick question -- is freeze-dried food still considered to be "raw"? would think that the processing would kill any bacteria (or viruses for that matter); bacteria can't grow if there's no moisture, at least that's what I've always been told

 

So his platelets were rechecked today and they are at 200 thousand normal. Last night were at 60 thousand. The vet said he is eating well and purring and acting good just said his blood is being funky. He isnt on insulin and is eating well and now his BG is too LOW! She said its about 60. They are very confused and wondering if lantus after 4 days is still in his system? I'm very confused too. Now he has to stay another night because they're worried about how low his bg is

 

BG<60 would not concern me one bit In a cat not receiving exogenous insulin. I regularly test my non-diabetic cats and get numbers less than that. I am actually surprised that they would be concerned about that. Plus he hadn't been eating much before now so you'd expect it to be lower anyway. In my experience there wouldn't be much Lantus left if any after 4 days, or certainly not enough to lower bg much.

But eating and purring is good news! Cut out the platelet mysteries, Morton!

 

I think because it rapidly changes like it was over 400 while in their care and he was insulin resistant they thought because he had his pancreatitis, sepsis and dka so they were doing r insulin IM and not doing a thing. Then the morning after he came back his bg was 140 I had to skip insulin the night before because he wasnt eating or that day or the next day. And when we checked him in yesterday his bg was 80. Now its 60 and they said hes eating really well and no diarrhea like he had at my house. I hope the severe nausea was just the antibiotics he had 3 he was on the clavamox was instantly stopped they said that could have done it but I know it can stay in the system a while maybe the fluids hes on flushed it out? They said he's doing amazing. I'm just so worries he wont eat when he comes home hes a bag of bones for being a baby. His cbd pills will be here tomorrow and the reviews I've read said people actually had to stop giving them to their kitties because their appetite was too increased. I hope it happens to him

 

It might be best he still stays since his platelets dropped so low within 2 days and now they're up to 200k. That is really the serious issue here is cold turkey stopping his immunosuppressive drugs over a week ago

 

So they want to keep him ANOTHER day because hes not on insulin and now his bg is 50

 

???????

I'm going to assume that these are pet meter numbers since it's at the vet. 60 I wouldn't be too concerned about when not on insulin, even though it's lower than our "take-action" number of 68, as some cats do naturally run low. 50 is kind of pushing it, though-- it does happen, but is fairly unusual.

Do they have any guesses about what is going on?

 

They're testing for some things including addison's disease. They seriously OVERLOADED insulin when he was there for a week his bg wouldnt budge for days and at my work we tried IM injections before he got to the er and it didnt work. Now that his infections are gone hes eating and acting perfect but his bg is too low now. I just want him home. They want his bg to stay at 80 without sugar in his fluids.... sigh

 

It might be a good idea to start a new thread with a specific title like "Low BG without insulin?" and reference this thread for background.

I have a cat that regularly tests in the 40s. He is not diabetic, he has never received insulin. I understand that there is a lot going on with little Morton, and there are certainly things other than exogenous insulin that can cause lower BG that would be a concern. But I don't know that the lower BG alone seems like reason to keep him there (both due to expense, and for you to just see go ahead and how he does at home, because when he was home last he still wasn't eating well, right?). But I certainly encourage you to get other opinions. I very quickly found @Harukyo 's spreadsheet: https://docs.google.com/spreadsheet...mAonTsj_DKPmjKf8enqRDojX-bs63gCdq7_FS/pubhtml but there are likely others that I just couldn't manage to get my hands on that would show similar for cats in remission.

Look at Kyo's lime greens in late June, and in mid- to late-July. I agree that 50 on an Alphatrak or similar (including their lab equipment) is on the lower side, but... I just don't know. If there is nothing else that they are doing for him other than testing his BG and giving him a little sugar boost, which you could do with home testing and some FF gravy food, I would bring him home if he were mine. Of course they can't require you to leave him there., and I would just ask them to work with you on a plan to take him home now, what care to give at home, and what signs would indicate that he needs to come back. For financial reasons as much as anything else, but I know you'd just love having your boy back home and I'd hope it would help him out as well. Just my unsolicited two cents worth.

 

It is on an alpha track. And I believe he does like his gravies. They said hes eating really well there and no diarrhea (which are the reasons I brought him back probably a clavamox issue). So yeah.. I can though.