Meatball Vet Visit Follow Up

SO this AM, Meatball had absolutely no appetite. I basically forced him to eat some tuna, just so he would eat something. However, about 15 mins later, he's thrown in up, and I alreay gave him 1.5u insulin. His AMPS was 386 ... what to do???
I supposed to be leaving for work now, but hesitant to do that.

HELP!

 

Re: HELP ... Meatball not eating/throwing up!

this plus the ketones message you sent earlier says to the vet posthaste. DKA is a distinct possibility.

Read about it on the way to the vet:

http://en.wikipedia.org/wiki/Diabetic_ketoacidosis

 

Re: HELP ... Meatball not eating/throwing up!

Agree with Steve--get to the vet! Better safe than sorry. Ketones can act quickly.

 

Re: HELP ... Meatball not eating/throwing up!

I agree with them both. Need to take poor Meatballs to the vet and not go in to work yet.

 

Re: HELP ... Meatball not eating/throwing up!

I want to chime in and agree with everyone else. I went through the exact same thing with my kitty Whistle last week. No appetite, vomiting, very high bg. Turns out she was DKA and had kidney disease (I had no idea about the kidney disease prior to this episode). An immediate vet visit saved her life.

 

Re: HELP ... Meatball not eating/throwing up!

Hello... well I ended up at work before I got all of these, did what I had to do, and just got home a little bit ago. Tried to feed meatball again, he ate half a can of food, and drank some of the water I mixed in with it. No more vomiting since this am. However he is still not acting normal.

I noticed this am, but did not really process, that fact that when he vomited this morning, it was the food he ate last night. A couple of people have suggested he might have a hairball?

I just tested his blood glucose, +6 360.
I have not been able to test ketones since 8pm last night when it was between none and trace. I have a very hard time telling between the two.
What do you think?

I was thinking to try to convince him to drink more water so he I can test his ketones asap.

I'm hesitant to go to the vet today b/c my regular vet does not have any appointments until Monday, and I have not heard great things about the Emergency walk-in place I know I can go to w/o an appointment.

 

Re: HELP ... Meatball not eating/throwing up!

In your place, I would back Meatball up and go sit in my vet's waiting room until they agreed to check him. There's no excuse for a practice refusing to see a regular patient who may be in serious trouble.

 

Re: HELP ... Meatball not eating/throwing up!

Finally able to check ketones, they are medium... and we are going to the vet.

I have read about Ketoacidosis, and I understand the technicalities of why it happens and what it is, but what I don't understand is how you know when it is bad? what the treatment entails? what this means as far as his overall diabetes treatment? Do I need to do something differently?

So confused about why this is happening NOW when his number have certainly been higher than they are now...

Anyway, off to the vet.

 

Re: HELP ... Meatball not eating/throwing up!

(((Molly))) I'm so sorry you are having to take Meatball to the vet. Any update?

 

Re: HELP ... Meatball not eating/throwing up!

I'm glad you took Meatball to the vet. Please update when you can.

 

Re: HELP ... Meatball not eating/throwing up!

Hi Molly, I'm anxious to see an update too. Hope Meatball is home, eating up a storm and keeping his food down.

 

Re: HELP ... Meatball not eating/throwing up!

Of course when we got to the vet, Meatball was acting as if he was miraculously recovered ... that's the adrenaline right?

I had a very long conversation with the vet ... she was just as confused as the other about Meatball being so young as the other Drs have been. She reviewed his BG numbers and dosages and wants me to up the dose to 4u, which I told her I would do, but that seems like too much of a jump from 1.5, so I think I'm going to stick to the plan, and raise his dose a bit more slowly, but more aggressively that I've been doing. I'll up the dose every 2 days if the numbers are not lowering.

As you may know, I was really wanting to switch to Lantus, but she seemed adament about not doing that right now when he is so unstable, better to just get him into a more safe place before making that switch.

I was somewhat surprised that she did not actually DO anything. I went in there expecting at least a shot of fast-acting insulin and some fluids, but there was no insulin, and only fluids b/c I specifically asked for them.

I am going back today, as the vet called me after I left the clinic last night and wanted me to have him checked to make sure there was no infection in his body left over from the UTI he had last summer. Apparently that can make a cat difficult to regulate - at this point I would never be so happy to hear that Meatball has an infection, at least it would answer some questions.

So, when we got home last night Meatball was definitely feeling better. He ate some food, and drank a bunch of water, even though he had just gotten the fluids. His PMPS 550... though this was at 11:00pm last night, and I usually take a reading at 8:00pm. He ate this morning as well, his BG is still high, 506, even after the 2u last night...

Thanks again for all of your support!

should I do a curve today?

 

I'm still new to this as well, but numbers in the 500s while taking insulin is WAY to high! Have you checked for ketones again? I think I would go somewhere else for a second opinion honestly. Your vet should have done SOMETHING while you were there - especially considering the elevated ketone level. confused_cat

 

I'm so glad he is eating well now & I'm glad you insisted on the fluids too.

I have read before about vets not using a fast-acting insulin unless things have reached a certain point of being REALLY bad, but I don't understand when they should or shouldn't be more aggressive, and how to judge whether or not they are doing the right thing. It seems frustrating to me (I mean, why bother adding to your cats stress by going to the vets if they're not even going to do anything!!!!), but I have heard of that before, and just don't know enough to know if it's vets who are missing the boat, or actually appropriate in cases where there are ketones but no DKA.

I'm not sure what to make of the 500s - stress from the vets? If you can get a couple spot tests in today that would probably be a good idea (although if you are taking him to the vet, I'm not sure how useful today's data would be - if that's the case, maybe save the curve til tomorrow?). You don't need to do a complete curve unless you want to (never hurts to have the data, but no need to stress him any further if he doesn't like the tests). As well as PSs, I would probably aim for something in the +4 to +6 zone (to look for a nadir) and something in the +9 zone (to keep an eye out for possible rebound, in which case you could see a dramatically high +9 or so, followed by a lower PS after that - I'm not expecting you will see this, but it can be useful data to confirm if you are getting a nice U-curve or not) if I felt like I'd only be able to get a couple tests in before he starts balking.

If you want to post in the PZI forum too, you may get some additional eyes on your data to help you make decisions.

 

Thank you, and I just reposted the information in PZI.

The numbers I have collected today:
AMPS 506
+2 370
+6 490

seems very strange...