Hypo Help -- Kitty Is GA

Our last post: viewtopic.php?f=28&t=30268&p=312484&hilit=Pancreatitis+Help+Lev#p312484

My foster cat, Kitty, was dx with pancreatitis and possible lymphoma or mast cell disease last week. After three days in a referral hospital, I brought her home Saturday with instructions to bring her back for more diagnostics if she doesn't improve. She hasn't eaten on her own since she got home! I've been syringing baby food into her three times a day.

She saw my vet yesterday, and the vet and I decided whatever else is going on trumps diabetes right now. Kitty's on pred now, along with a gazillion other things.

I gave her fluids and baby food at +9 (7 pm) and tested her. Her BG was 34. She's been that low before but never showed hypo symptoms and ate enough to bring herself up. I knew she wouldn't eat tonight, so I put some Karo on her gums. That didn't do anything, so I syringed some into her.

At 7 pm, she was 34
7:20: 44
7:39: 40
7:45: 39
8 pm (+10) 43

I gave her Karo after every test.

How often can I give it to her? Can I give her too much? I have "grilled" Fancy Feast and Whiskas pouches. Would it be better to try to rub some of the "gravy" on her gums? I don't want to take her to the ER, because I think given her overall condition they'd just want to PTS. But if I did take her, is there anything they'd do that I can't do here?

Until tonight, she was usually in the low 200s-high 100s. This morning, she was 145, and I probably should not have given her insulin. She gets 0.05 u of Lev bid.

I realize the disease process could be shutting everything down, but I keep hoping we'll put through this somehow and she'll be okay, at least for a little while. She was such a wonderful, personable cat with so much attitude until she got so sick. She was adopted and returned to a shelter twice before she came here. I keep telling her she has her forever home with us now. All she has to do is get well.

 

Re: Hypo Help -- Up to 50 Now

I have never had much luck with the karo syrup myself.you might also want to try regular vanilla icecream or regular yogurt.if you can syringe just the gravy or anything else high carb into her the numbers should go up. The insulin should also start to wear off if you gave it to her this AM.I would definately skip the evening dose and see where her numbers are tommorrow morning. It is probably safer to run a little high rather than to risk going hypo.hopefully some other readers can also help guide you thru this.My cat went down to 35 once and I gave him melted vanilla icecream that brought him back up to the 60s.It is scarey. Purrs and good wishes from my kitties to yours.

 

Re: Hypo Help -- Up to 50 Now

I don't have any ice cream, although I wish I did. I could use some myself. Chocolate would be even better. I do have yogurt though. She might like that.

 

Re: Hypo Help -- Up to 50 Now

I have had luck with Karo the one time I used it. My Bailey did have symptoms. I used a standard 3 ml syringe to get it into her mouth similar to what you are doing. I would give a little every 1/2 hour or so. If you can keep it about 40 with no symptoms he should be alright.

 

Re: Hypo Help -- Up to 50 Now

She seems to be holding at 50. I just wish she'd eat something on her own. The doc at the referral hospital said to not give insulin if she was under 200. I'm so worried about DKA since she's not eating, but maybe he was right.

 

Re: Hypo Help -- Up to 50 Now

200 is the don't shoot number that we tell newbies, so she should be ok. Keep trying to get her to eat. If she likes the flavor of the gravy, you may want to try puree some of the cat food with some water to make it very soupy. It will make it easier to syringe feed if needed.

 

Re: Hypo Help -- Up to 50 Now

She doesn't like the smell of anything, but pureeing some of the high-carb food and syringing it into would give her more carbs and calories, which she needs. I'll try that. Poor cat... she just asked to go outside. Not a good sign. She's back in her bed now looking miserable.

 

Re: Hypo Help -- Up to 50 Now

If she has pancreatitis, are you giving famotidine (Pepcid)? Charlie had CP, IBD, diabetes, and kidney issues and pretty much had to have pepcid on board the last year of his life else he wouldn't eat...

 

Re: Hypo Help -- Up to 50 Now

I'm giving pepcid, cypro and bupe. Nothing is working. It's like she's resistant to everything. I just tested her, and she's down to 32 again. My vet gave me some Royal Canin Recovery, and I mixed some with Karo and syringed that into her. The Recovery is very hard to syringe, or very easy for the cat to spit out, so she didn't get as much as she should have. It's been 13 hours since she got insulin.

 

Re: Hypo Help -- Up to 50 Now

missy, in our experience, fluids if 75 ml or more can bring down meowzi's BG two to five hours after it's given. i don't know if that's what's happening with kitty - don't even know how much she had.

 

Re: Hypo Help -- Up to 50 Now

She got about 75 ml. Maybe that is what's happening now. I'm so scared, and I feel so sad for her.

 

Re: Hypo Help -- Up to 50 Now

hang in there, k? if it's the fluids, should be wearing off pretty soon and she'll start climbing. will she eat any high carb treats?

(((missy)))

 

Re: Hypo Help -- Up to 50 Now

She won't eat anything. She just went to the door asking to go out again. Good that she's walking around; not so good that she wants to go out. I'm going to test again and try to get some more food into her.

 

Re: Hypo Help -- Up to 50 Now

hi missy ,

I missed your original post on p-titis.
Does kitty have chronic p-titis or acute? I thought the plasma was a little unusual for an initial treatment for chronic, but every vet has treatment protocols they like best.

not sure where to start so I'll just jump in somewhere in the middle.

pepcid isn't the greatest for nausea for p-titis and appy stims won't work if the kitty is still nauseous .
I had great luck w/ ondansetron for kitties w/ ptitis and lymphoma. it is very inexpensive prescription med. it comes in either pill or injection. I had easy pillers, so I went that route. The *big* p-titis vets ( zoran,marks, scherk) all recommend its use. If your vet is unfamiliar, i would be happy to post the dosing ranges for you .
If there is vomiting -- then cerenia shots can really help. They can only be used so many days in a row though.
and to note, they can be used along w/ the ondansetron. ( and yes you can give the pepcid with both of them. )

your post said Kitty was on mirtz in the hospital but on cypro now-- why the switch? I had much better luck w/ the mirtz -- as long as the nausea was controlled.

how much pred is Kitty on? and for how long? I'm a big believer in roids for p-titis. you can always shoot around them. sometimes challenging, but doable.
and if it is a low dose and not showing signs of being effective ( KItty feeling better, eating, etc...) then I would ask about increasing dose. The *usual* starting dose for pred w/ IBD/p-titis is 5mg BID. It's late , i have the links if you want just ask ! The other option , is a switch to dexamethaxsone. It is harder on FD, but for the possible lymphoma factor , often will work , when pred does not. I have personal experience with that x2kitties. and if a switch is made, I highly advise using a loading dose of dex to really knock things back. ( I used oral)

Pain control. bup really helped a lot here. Is Kitty showing signs of pain other than not eating?
ie meatloafing? hiding? it is possible the dosing may need adjusted.

I would highly recommend B12 injections. they can be given in the fluid port or separately.
again very cheap. big bottle I pd only 5 bucks.
here is link from texas on that for GI disorders. The Lymphoma, IBD and p-titis vets all recommend.
http://vetmed.tamu.edu/gilab/research/c ... nformation
with anemia also present, I would also use a multi B vit injectable ( these sting so best w/ the subQs)
also inexpensive. There is not enough B12 in them for GI therapy. You don't have to worry about giving too much B12. Multi B's can also perk the appy.

denosyl is a powerful antiox and can help the p-titis and GI issues as well as be a prophylactic for a kitty who is in danger of HL from not eating. If the liver looks like it is an issue, then I would use the denamarin. Try to dose this as far apart from pepcid as you can. It has a thick coating and needs some acid for the thick outer coating to dissolve in the gut. We had a few whole pills show up in the LB. The folks at nutrimax suggested smashing the pill and giving immediately. we would lose a little potency, but enough and better than coming out whole ! just something to make sure you look for in the LB if you use denosyl or denamarin.

prozyme is a veg. based prebiotic and helps to break down food and ease digestion. i recommend that too.
and if there is diarrhea ( and with the ABs some probiotic like culturelle or fortiflora can help)

On this thread, if you scroll down, I have a post on things to entice appetite and touch on other options :

viewtopic.php?f=28&t=26965
I hope something there can help

The thing w/p-titis flare, is it really needs to have all the *guns* thrown at it to knock it down. It sounds like you are already doing a lot.

As for the possible lymphoma. There is really no way to determine if it is IBD or L w/o a full thickness biopsy and immunohistochemical testing done on the biopsy. that means opening up .
Severe IBD can mimic L to the point of it causing tumors( but they are benign) Steroids can skew any biopsy tests.
This is an expensive and obviously physiologically stressful on the cat. With the p-titis that may not be the best.
Most will treat in situations like this as if it were small cell lymphoma.( and since your vet is already convinced of the dx that is not an issue for you, as it can be for others) That usually means pred and leukeran. With the anemia , I'm not sure the leukeran would be advised at this point. That is something to ask the vet. And also to decide how aggressive you wish to treat.

You might want to give Jess a holler, she might have some more ideas for you .

I'm so sorry Kitty is so very sick. I know you have become very attached to her.

(((((( missy & kitty ))))))

ps. I wrote this in the wee hours, so forgive the jumping around. If there are any clarifications or if I can help further please let me know. I can offer references for meds I may have not provided them for in this post.

I hope kitty eats soon. If KItty has been on the pred w/ no improvement for a more than 3 days, and is doing poorly, that is personally where I would get more aggressive at this point. you can always taper back, if the situation allows.

I will look for an update.

 

Re: Hypo Help -- Up to 50 Now

Try sprinkling a little parmesan cheese on top of her food or adding some tuna water to her food to entice her to eat!!! Good luck!!!!!!!!!!!!!!!!!!!

 

Thanks for all the information Cheryl. My wonderful Kitty is GA. Since she got home from the referral hospital, I've been telling her she's been officially adopted -- by me -- and that she was in her forever home, really forever, no more "returns" to shelters. Before I finally went to bed last night, I found her on a chair in my office (she'd never been on that chair before), and I sat with her for a long time and told her how much I love her. I was surprised that she had the strength to get to my office and up on the chair and actually felt optimistic that she would be okay. This morning, I found her in her bed in my bathroom, which was her private apartment.

I had a feeling last night when her BGs went down to 27 13 hours after her last insulin shot that everything was shutting down. I'm just grateful that we had our long, loving conversation in my office last night and that she was here not in the hospital surrounded by barking dogs and people who didn't know her and how amazing she was. Very sad day here...

 

(((Missy))) I am so sorry. Kitty was so lucky to have found real love in the end and to pass with love and comfort in her heart. Fly free sweet (((Kitty))).

 

i am so sorry, missy

 

I am so very sorry for your loss. But it sounds like a good ending, and wonderful that she had that time with you in your office.

 

Such sad news; sorry for your loss, but glad you were able to spend her last time together.

 

(((((Oh Missy)))))) I am so so very sorry for your loss, I know how much you loved Kitty. But take comfort in that in the end she knew true love and choose her own time and her own why to say goodbye. I'm really happy that you two got your long talk in your office last night. She is probably right now waiting for Stu to whip up one of his famous Thanksgiving dinners, and celebrating with all of our other GAs.

Fly free Sweet Kitty, enjoy those angel wings and watch over mommy.

Mel & Max and the fur gang.

 

((Missy))
Tears here. I am so sorry that Kitty has crossed.
What a hard life she has had but thanks to you taking her in,
she found the love she so deserved.

Fly free sweet Kitty. wings_cat

 

my deepest condolonces for your loss.
Fly free sweet Kitty

 

I am so sorry for your loss of Kitty. You did everything you could and loved her as your own. Fly Free, Kitty! wings_cat

 

((((((((((((((((((((((((((((((MISSY)))))))))))))))))))))))))))))))))

I am so very sorry Kitty had to fly over the Bridge. You are a great mommabean and we thank you so very much for taking her in. Kitty is whole and healthy now, and my Merlyn will look out for her in the spirit world. Many tears here. rb_icon

wings_cat

 

I'm SO SORRY (((((Missy))))) Fly Free Sweet Kitty!! wings_cat

 

(((((((Missy)))))))))

When you told her she was in her forever home and would be forever loved, she knew she was safe and was free to let go. I'm sorry she had to leave you so soon.

Fly free, little Kitty. wings_cat

 

I am so so sorry to read about your loss. I am grateful that she was able to be home, her forever home, when it was her time. She is whole, healthy and happy now, no doubt enjoying being so with all the others at the bridge. rb_icon

Fly free sweet kitty wings_cat

 

(((((missy)))))
i'm so sorry to read this.

wings_cat fly free, little Kitty...

 

I am so sorry for your loss!!!! It is nice that you and Kitty had that talk, and that time together...Kitty knew she was finally loved in the end!
Tears flowing here..... (((Missy)))
Fly Free, sweet kitty! wings_cat

 

I am so sorry for your loss. (((Missy)))

 

((((((((((Missy))))))))) I'm so sorry for your loss.
I'm glad that you had time last night with her in your office and that she was able to settle into her bathroom-apartment, in her bed and go peacefully in her forever home.
Many hugs and many tears.

 

I'm so sorry for your loss.
Fly Free Beautiful Kitty.
I'm glad she found her forever home.
Tears.

 

I am so sorry for your loss.

Hard to be thankful this day, but I am thankful that Kitty learned
she was home forever with you.

May you have wonderful memories of Kitty...

...'til you meet again.

 

(((Missy))) I am so sorry. Fly free Kitty rb_icon

I am also so glad that she was home and in a quiet place where she was loved.

 

(((((Missy))))) May you and Kitty forever remember your talk. And may she fly free, until she finds you again. wings_cat

 

Sorry to read this! Glad she was in your presence and was fostered by you. Such an adorable cat! Peace with you!

 

I'm so sorry Missy. Thank you for giving this precious little girl a few months of being loved. I'm glad you had "the talk" with her last night.

 

I am so sorry for your loss. I am glad she had all of your love and tenderness.
Peace

 

I'm sorry for your loss, Missy. At least Kitty knew she was loved and had her furever home. Fly free Kitty

 

So very sorry for your loss. Fly free Kitty.

Claudia

 

missy, i'm so sorry for your loss.
seems a bit like cleo's last day and i know how horrific it is.
you did what you could for kitty, and made her last day a loving one. it is so important for all beings to feel wanted and loved, and you did that for her.
(((Hugs)))

 

(((Missy))) I am very sorry for your loss. What a sad life your Kitty had, but in the end she had what every kitty deserves - a warm, comfortable bed and a loving home. Bless you for giving her that.

 

((((((((((( missy ))))))))))))))

I was so very very sad to come on and read this.

She was very lucky to have landed in your kind care and most importantly in your heart. She knows she is yours and that you are hers..... forever.

Peace sweet KItty. You were (and are!) loved. rb_icon

 

How very sad. I'm so sorry for your loss. I feel your sorrow. Kitty is in the loving arms of our Lord. She is safe.
jeanne

 

(((Missy))) - I'm so sorry about Kitty. poor little girl. at least she knew love before she left.

fly free sweet Kitty. wings_cat

 

Missy,

I am so sorry that you lost your sweet Kitty. At least she was home in her familar surroundings. I know you'll miss her very much. You did everything you could for her.

My thoughts and prayers are with you.

jan and sara

 

Missy, my deepest sympathy on the loss of Kitty. So thankful she was at home, in her bed and that you had that time together to talk with her. She knew she was loved......she knew that finally she had a home........and she passed away in her home, not at some vet clinic. You did everything you could for her and this is just so sad to read. My heart goes out to you.

 

Dear Missy, Your Kitty loved you and was grateful to be so loved in return. She chose her time and her place, and she chose to spend her last hours with you. Our GAs will look after her until you meet again. Fly free, sweet Kitty.

In deepest sympathy,
Ella