Do I take Sooty to the vets ???

Do I take Sooty to the vets today ?

He has been given 1u caninsulin this morning
+2 is17.1
Ketones yesterday 0.04.

He is lethargic, won’t eat, vomitting yesterday (twice and just liquid)
His recent bloods came back with very slightly raised ALT but nothing that the vet was too concerned about.

If I take him today (cost isn’t the issue) will they be able to do anything ?
I’m worried about him and confused cos can high bg mean inflammation ? Or infection ?

Please reply..........

 

Sorry another quick question - if he has an infection / inflammation and that is raising his BG do I give a higher dose of insulin based on his AMPS reading or will that be skewed if it’s caused by something ?

Would the bloods have picked up an infection ?

Sorry, confused again ......

 

Is he not eating at all? You really need to get some food into him - try the usual tempting tricks, eg Parmesan cheese, small pieces of flaked tuna, on top of his usual food, or try freshly cooked chicken in broth - liquids are important too. You don't want to risk ketones building up. If I were you I'd ring the vet today and explain the extent of any new symptoms since last week - see what he/she says. Ketoncs can develop quickly so you want to take steps to avoid this at all costs.

 

He’s had about half a plate of felix so he’s had some food and also about 3 small pieces of chicken
I’ve seen him drinking quite a bit first thing too

 

He’s just really grumpy and really lethargic and usually he wolfs his food down but it’s a real struggle today and yesterday
Could it be that he’s not getting enough insulin ? I.e I gave too little this morning ?
I didn’t want to jump from 1u to say 1.5 this morning in case it was too much and given his lack of appetite too

 

Does he have a history of ketones?
Could he be dehydrated? To test pull up the scruff of his neck and then let it go. Dies it fall back quickly or slowly? Also feel his gums. Are they slippery and wet or tacky to touch?
Are you able to get any tests in during the pm cycles?

 

He is probably not getting enough insulin because his spreadsheet says his numbers are still high. But you don't want to increase too quickly and risk getting low numbers that you're not used to. Maybe see what his PMPS number is and think about a "fat" dose which is just a tiny bit over a dose. A "skinny" dose is a tiny bit under. If you can get a few more tests today without hassling him too much, that could be helpful, to see how he's responding.

Other than that, it's hard to know what to say about symptoms like "grumpy" and "lethargic"... certainly signs that he's not feeling too great, as is drinking a lot - all not unusual at all in a cat with high blood glucose. If he's eating, that's a good sign - really poorly cats lose their appetite completely.

I'm still a bit confused as to when these symptoms started and whether they coincided with bg going up. You were saying that things had been going well until recently, but then he had an infection that raised bg? Maybe that unsettled his system and his metabolism needs to readjust in some way...

I think all you can do at the moment is carry on as you are - make sure he's eating, stick with the current dose for now, continue to check for ketones, and keep a general close eye on him for any signs of real discomfort or pain. It doesn't sound to me as if he needs a vet visit at the moment, but you're the one there with him and would know I think if he was really unwell. When in doubt, at least ring the vet and explain - they'd either say bring him in or just keep watching.

 

He’s got no history of ketones - I bought a blood ketone Monitor and have tested a few times - all under 0.05 (which I believe is normal)

I’ll check his bg this afternoon at least once so I know where we are heading and will probably do a 1.25u dose tonight (depending what the PMPS is)

 

Hi Diana - it’s all a bit confusing for me too

A few weeks ago he didn’t seen himself (off food and lethargic).
I took him to vets to see and they said temp high and so gave a shot of antibiotics and anti -inflammation drugs (Metacam I think)
Whilst he was in antibiotics he was fine - having his 2u AM and pm.
Then after antibiotics had finished (2 weeks later) he went off his food again and back to being lethargic.
I started testing his blood more frequently and that’s when I started to get the strange numbers (Am shot in the high teens), mid cycle BG down to 4. And that’s when he started to vomit too.
I think I may have dropped his insulin too low for too long and maybe kept him at 2u (although one morning reading AMPS was8.6)

 

Is he still having the metacam? If he’s vomiting I would not give him metacam.

 

Good point - it could be this that's upsetting him.

 

He had an injection of Metacam at the same time as the antiobiotics (about 3 weeks ago) and nothing since

 

Ok. It was the oral that can sometimes cause vomiting that I was concerned about.

 

I'm really glad of your input- I don't know what's going on and I just want my little man happy and healthy.
Is it worth getting a urine sample to check for anything?
Would the blood test have picked up a uti?

 

Yes the blood test would probably have had high white cell count if there was a UTI, but I think it is always worth while getting a urine sample to have it checked.
Did they check for pancreatitis? There is a blood test called a fPLI which will tell if there is pancreatitis. It is not in the normal blood count test but a separate one. Symptoms can be not eating, nausea, vomiting, lethargic, dehydrated and diarrhoea. It might be worth asking the vet about that.

 

T

The symptoms you describe sound a lot of what sooty is experiencing.
I'll ask vet tomorrow for that blood test?
If he has got pancreatitis can I do anything to help him ?

 

Yes. If it is pancreatitis, the vet can give him an injection of cerenia for nausea and then give you some cerenia tablets to take home. They need help with nausea for a few days sometimes longer. Also an injection for pain. Usually bupe. And ask for some pain meds to bring home.
He might also give some subQ fluids for dehydration which the vet can do during the appointment and may suggest some subQ fluids to be given at home.
It is mainly supporting your kitty while he recovers. Some kitties can get a flare up at a later date so it’s good to have the medications at home.
You will need to tempt him with whatever he will eat at first as long as he eats.
Has the vet mentioned swapping to a longer acting insulin such as Lantus or Prozinc?

 

That's great advice thank you - I'll write this all down and take with me.
Yep we are going into prozinc ! Hopefully end of next week. I'll need lots more advice then.
Can u switch over 1 day ? I.e a Thursday Caninsulin and Fri prozinc?

 

Yes you can swap over after a 12 hour cycle. So you give caninsulin at AMPS and then Prozinc at PMPS.
When swapping over from one insulin to another you take into account your current dose so as you are giving 1 unit you would not give a larger dose than that when starting Prozinc.

 

Yes great advice from Bron! Of course it may not be pancreatitis, but if not at least you can rule it out and look at other reasons why these symptoms are recurring.

 

I’ll ask the vet for the blood test for pancreatitis and see what that says.
I’ve just done a bg test - 20.4 (he’s too high).
One thing the vet has said is that his teeth are pretty bad and may be causing inflammation which I think ??? In turn can cause the BG to rise ??
I’m in a bit of a dilemma about this one - he’s nearly 20 - do I put him though an operation to sort his teeth at this age and also how will that affect his ability to eat and therefore get his insulin ?
Sorry for all the questions !

 

Yes 20.4 is too high and may well be contributing to lethargy etc irrespective of any other issues.
Bad teeth can definitely cause infection and therefore high bg and this is not going to go away. It is a dilemma I agree, but it would be good to do a dental anyway if the vet says his general health is up to it. If he had to have extractions that shouldn't cause too many problems - cats seem to manage to eat just fine with very few or no teeth.
I'd suggest get the fPLI test done and while you're there ask the vet to have a good look in Sooty's mouth to see how bad his teeth are - any obvious signs of infection/inflammation should be treated one way or another.

 

The vet says as the bloods have come back reasonably ok she wasn’t too concerned about the anaesthetic etc. He would be on fluids through the procedure. His teeth are bad (every time we go we get a comment about this).
One thing the vet mentioned is that we try ProZinc first and then look at his teeth ?
Does it matter If both are done at the same time ? I.e switch to ProZinc and get teeth done at the same time ?

 

I have a kitty who had to have most of her teeth out when she was very young due to a problem with the gums and double teeth growing in each spot. She was fine afterwards as far as eating goes and eats a raw diet with small pieces of meal with no problems.

 

Getting the teeth/mouth sorted is probably the priority as if you try PZI first, any dental issues will still be there. So get the dental done and just start the new insulin straightvafterwards.

 

Ok that makes sense.
Vets tomorrow morning to a) ask for blood test for pancreatitis and b) get him booked in for dental work (I’m sure he’ll feel better if his teeth are as bad as the vet says).
Will also probably up his insulin later to 1.25 (the 1u this morning was definitely not enough).

 

Yes he will feel better for a dental, it's no fun having a sore mouth.

 

That also might be why he’s stopped eating so much (maybe his mouth is sore (only guessing though - I do wish he could talk !!! - it would be so much easier !!)

Thanks for all your help (again).
Some days I think I’m losing my mind worrying out him and what to do for the best

 

It's very likely that mouth problems are what's making him stop eating - the fact that he seemed better when on antibiotics bears that out too, ie they helped with the problem, but now that the course has finished, his discomfort has come back. Yes we are only guessing but it's only by taking action and ruling things out that you'll get to the bottom of it.
It is a worry, we all worry ourselves sick about our kitties, but knowledge is power and you have a couple of things now to suggest to the vet that will improve things. You could carry on for months not seeing any improvememt in bg if you didn't at least try.
Paws crossed things will improve soon

 

Hi Amy, how did things go at the vet's?
How is Sooty doing?

Eliz