Help please--DKA survivor not eating/drinking

I've been posting about Smokey before and here is a recap:

She had DKA a week or two ago (been so worried I can't even keep track of time). She survived. Tests at the hospital and vet (no ultrasound or x ray, just blood urine etc) revealed ever so slightly elevated kidney levels, and nothing else apart from ketones/DKA.

Since surviving, Smokey has only eaten well one day, I believe when her BG was controlled, and she was given an anti nauseant. The vet sent her home when she started eating. She went downhill. We brought her back. An X ray revealed her stomach to be larger than it should be. He gave her meds to help her stomach empty. A follow up X ray showed the stomach emptied and was back to normal size. She's still not eating or drinking well. He sent her home to see how she would do tonight, and if being at home would help her.

We've given her an appetite stimulant but she's not eating much, not drinking at all, and sleeping more than usual, both naps and just plain lying down when she's in the middle of being awake and checking things out (not normal for her). We're calling the vet tomorrow; he is worried and wants to hear how she is doing. It also turns out (didn't know this) he doesn't have ultrasound with him; it comes to his office certain days of the week. So he won't have it til next week, I think Wednesday. I'm really worried about my cat right now and my vet is too. He did say if she's not better we'll run other tests, maybe more on the kidneys, and of course the ultrasound. I'm worried about waiting until Wednesday. I could bring her to the hospital again but her bills this week have been about 5K already... hospital would charge a fortune I'm sure, and they haven't been the ones monitoring her for the most part, but could get the ultrasound sooner.

I wonder if she could have pancreatitis? My poor angel is so thin her body width almost fits in the palm of my hand. The fact that she ate well when on anti nauseant, at least that one day, made me wonder about that. What would you do? I know I'll see what the vet says tomorrow, but about the ultrasound, and testing sooner? The vet also forewarned us, that there could be something wrong, and the ultrasound may not show it necessarily. I feel at such a loss for what to do. I love her and want to nurse her back to health. I'm at home with her all the time and am not seeing my family this whole thanksgiving weekend just to monitor her and make sure I get to enjoy every second with her.

Oh also she's on 1 unit of humulin N twice a day (vet doesn't think switching insulins is a good idea right now). Her BG is in 100s at peak, and 300 at time of shot. For her that's pretty well controlled (compared to DKA numbers for sure).

Prior to this whole thing I took a stool sample to the vet b/c I saw a worm after she sat on me. She's an indoor cat and vet didn't think it was likely, but had her tested anyway and she was negative for worms. She hadn't been peeing as much as usual and when I tried giving her even half a unit of insulin she acted like she had low BG. So that's had me worried--that she had a prior medical condition which kicked this whole thing off. But if she survived DKA with something else undiagnosed, that proves how strong she is and I have faith she will fight through this too.

Any advice appreciated,

Smokey's anxious mommy, wanting to restore her angel to full health.

 

Hi Smokeys Mom:

I have no advise for you as I am new. However I did want to acknowledge that you must be really scared. I hope other folks have some great advice for you. I did have a time when my Jack was first diagnosed and he wouldn't eat, my vet gave him chicken baby food and he ate it right up. It started him back on his food after a few days. If you try this remember just plain chicken. It may be a bit hard to find.

 

I'm so sorry to hear your Smokey won't eat for you. I know how that feels first hand. I was able to jump start my Teddy a few times by giving him a treat beside his food bowl. Seemed he never could resist them. My regular vet didn't have access to the ultra sound, either, but he was able to do an x ray in his office. I don't know if that would be helpful for you.

Sending prayers and good eating vibes
Carol

 

I'm not sure if it will help your kitty, but when mine was off of her feed for several days (pre-diabetes), my vet suggested I mince hard boiled egg (white and yolk), mix a small amount with water and syringe feed her little bits.
For some reason, it stimulates their appetite. I've looked up the carb content for eggs and its extremely low, so I don't think it would hurt. Just a thought. In Molly's case it worked, but she
wasn't sick, just off of her feed after a dental. Something about once they go without food for too long they just lose their appetite. It may be something more serious in your case but I hope not.
I hope your baby is feeling better soon. Sending good thoughts

 

Thanks so much you guys.

When I speak to the vet tomorrow I will definitely ask about a syringe for force feeding if need be and different suggestions for tempting her to eat. I remember he'd fed her baby food chicken or chicken broth that way. Also thanks for saying once they've been off food they loose their appetite. That gives me hope that it may be something minor.

Now that I've had time to think more clearly, I remember it's been two weeks since she first went into DKA. Sometimes it sounds like her breathing is a bit laboured, but when they listen to her they say she's not congested. Maybe it's just because she lost all that weight and is weak.

Though she is still sluggish, in the past 5 and a half hours she managed to eat almost a full half can of wet food (after just picking at it for awhile) and drank a whole bunch of water (after refusing to drink for awhile). I have a feeling that that was the appetite stimulant kicking in. Vet says she shouldn't need one at this point.... she seems to go through periods of times where she eats and times where she doesn't. I just hope that if I keep her with me after Saturday afternoon, she stays stable.... otherwise I'd have to go to the ER with her and am running out of money.

Oooh she is eating right now too. I'd given her a new can of wellness chicken and she was begging for food but refused to eat it. Now I put in some dry food pellets and she appears to be diving right in. Yeah, I know we all know that's a no no, but the vet says that since she is on insulin it's okay, plus she's being monitored closely at this stage anyway. He said any food she eats at this stage is more helpful than harmful. Yay for Smokey eating (and hopefully she manages to down some wet food too)! Hoping she keeps this up all through the weekend and until vet can do ultra sound.

 

Glad to hear she is eating. My only eating tip would be when my cats won't eat, I sprinkle their food with Fortiflora, for some reason, they can't resist it. Best of luck with Smokey!

 

Thx, lynn and bear. Btw your cat looks like mine.

 

Pancreatitis is always a possibility or something else. I would try to get an ultrasound done sooner than Wednesday. If you live in a remote area that may be difficult. Do you home test? If Smokey isn't eating well I'd be worried about hypo. Do you have anything for nausea? I'd also be concerned about dehydration. I'd ask the vet about subq fluids.

Sandy

 

So glad to hear that Smokey is eating!
I know you're still worried. You've both been through a lot. Sending continued good thoughts.

 

My tux, Mr. Sluggo was anorexic after his run-in with DM, though he never actually had DKA. He had a feeding tube for 2 1/2 weeks and I was giving him ground up purina DM through it. Pancreatitis was a definite possibility, but the lab study for it was never done. He eventually threw up the feeding tube & I had to get him eating SOMETHING or it was time to consider euthanasia; the vet was nudging me that direction. What I came up with in my web searches was meated baby food. I found he'd eat gerber's chicken baby food (NOT turkey, ham,...). Now, that is nutritionally incomplete, so the vet had me try Hill's A/D. By itself, he wouldn't eat that, but mixed 1:1 with the gerber's baby food he would, and that's complete food for a cat. So, what I have to suggest is Gerber's meated baby food (make sure it has no onions in it). And beware it's not nutritionally complete for a cat, so you'll need to mix it with something else eventually. It's just a bridge to get your baby up & going. I also had horrible blood glucose control issues with the hill's A/D and baby food mix but at the time that was a secondary issue. It was "eat or die" time for my kitty and it sounds like you're facing similar issues. He actually put on a pound and a half on that mix before I started moving him to something better for a diabetic. I needed to get him away from the edge of the cliff... or maybe it was the light with the beautiful music and the chimes...

There is a specific blood test they can run for feline pancreatitis. Can't remember the name of it, but it's not your garden variety amylase. It's something more exotic. Ask the vet about it. I just remember being mildly irked that my vet was suggesting a pancreatitis diagnosis, but hadn't run the test when I did find out about it.

Hope that helps.

 

If light pressure on the abdomen results in pulling away, flinching, growling,hissing, and/or swatting at you, it suggests the abdomen is painful. Non-specific, but would support a dignosis of pancreatitis and/or hepatitis and/or inflammatory bowel disease ... and more than one could be occurring.

Sometimes, giving 1/4 tablet of regular Pepcid a bit before feeding may calm an overly acid stomach. You may want to check your vet is OK with that, but if it helps trigger eating, it could be worth doing. It may be dissolved in some water in an oral syringe to administer or given as a tablet followed by a CC or 2 of water to ensure it goes all the way to the stomach.

 

Thanks guys.

I was able to pick up my cat and hold her body against mine, and she didn't flinch or growl, so maybe that means her abdomen isn't painful. Though I assume my vet may have already tried it.... I will try poking a bit at her (later). I just tried petting her stomach and no reaction. They may well have run the tests for pancreatitis already.... not sure.... both the hospital and vet ran a whole bunch of blood tests, but I didn't ask about any of them. I know they checked her organ functions and everything was normal except slightly elevated kidney levels.

Yeah Smokey baby loves baby food, chicken flavor. If it spiked your cat's BS levels, that explains why she was drinking a lot before shot time. That's a good idea to mix the foods, because originally she ate wellness, then the 2nd can she picked at and only would eat the baby food. So mixing should be a nice compromise.