New sugar momma with diabetic cat who has swollen face

Discussion in 'Welcome to the Group - Post an Introduction Here' started by skinky44, Dec 28, 2014.

Thread Status:
Not open for further replies.
  1. skinky44

    skinky44 Member

    Joined:
    Dec 19, 2014
    My cat was just diagnosed with diabetes Dec 17th as well as a secondary issue with swollen face. She was given Convena, which had been helping with the swollen face/eye, but now it seems to be coming back. I have a follow up appt to see vet on Tuesday for an insulin demo. She is between 15 and 16 and vet is suggesting CT scan as he believes there is a secondary issue at work. I think he suspects nasal cancer. I can't afford to do the CT scan, and am hoping the swelling on one side of her face - the bridge of her nose, is something else.

    A wonderful woman, Jennifer, came by yesterday and showed me how to home test. She got a reading of 218. Today I got a reading of 250. Jennifer also saw how my girl has difficulty breathing at times, some open mouth breathing and her eyes look kinda glazed, especially on the one side which is swollen.

    I'm trying to arm myself with questions for the vet and drug/antibiotic/ testing alternatives, which I'm trying to be smart and cost conscious about as well...

    I'm uploading her blood work - if anyone has any insight into this that would be great as well..

    Appreciate any help you can offer...

    Many thanks!
     

    Attached Files:

  2. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Definite signs of infection with the high white count. Antibiotic choices are often a guess based on what has been seen in the community. If the guess is right, it'll help; otherwise, a different one may need to be tried. Ideally, a culture and sensitivity are done to identify the optimal antibiotic.

    Sterile, preservative free moisturizing eye-drops may help loosen crap in the sinuses - the eyes drain into them, so you put drops in the eyes to help flush the nose.
    A warm, wet cotton ball may be used to loosen and wipe away crusts around the nose.
    If you have a humidifier and can plug it in the bathroom, that may help loosen stuff for drainage, too.
     
    skinky44 likes this.
  3. skinky44

    skinky44 Member

    Joined:
    Dec 19, 2014
    Hi BJM, she does have topical gentamicin drops I"ve been putting in her nose and eyes. Her nose does not have any snot coming from it. there's a large, soft "mass" within the bridge of her nose...or that's how it feels anyhow. audible difficulty breathing. Not sure if I should start insulin now or not...
     
  4. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Insulin will help keep her stable. The last thing you need is diabetic ketoacidosis from not enough insulin in addition to whatever is happening.
     
  5. Dyana

    Dyana Well-Known Member

    Joined:
    Dec 28, 2009
    Has an abscess to her face or a tooth been ruled out?
     
  6. skinky44

    skinky44 Member

    Joined:
    Dec 19, 2014
    I guess..I took her to two diff vets who opened her mouth and did not feel it was a dental infection....
     
  7. Dyana

    Dyana Well-Known Member

    Joined:
    Dec 28, 2009
    I just know that cats often get abscesses in their face from cat fights. Puncture wounds from a bite can heal over on the outside too quickly, and leave an infection that can't get out on the inside.
     
  8. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Explore the skin surface as closely as you can. I once found a small puncture on a swollen paw; the cat had been bitten. I had to trim fur away in order to see it.
     
  9. skinky44

    skinky44 Member

    Joined:
    Dec 19, 2014
    She's an indoor cat..no bites...
     
  10. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Any acne? Insect bites?
     
  11. skinky44

    skinky44 Member

    Joined:
    Dec 19, 2014
    No. She is having a difficult time breathing. Now, she had developed a slight gurling noise in the throat in addition to the nose. her eyes can be glazy and one eye, from the swelling around her nose, can get partially closed.
    no acne, no bites.
     
  12. Marje and Gracie

    Marje and Gracie Well-Known Member

    Joined:
    May 30, 2010
    Betty asked me to take a look at Skinky's labs. I definitely agree she is diabetic and I strongly urge you to find a vet to work with you on getting her on insulin.....tomorrow.

    The thing that concerns me about Skinky's labs are her high neutrophils and low lymphocytes. Neutrophils are of two types: segs (mature) and bands (immature). Greater bands can mean severe bacterial infection. I am not a vet but I do have to wonder if there is something more than infection going on since she has zero bands and all segs plus the low lymphocytes.

    Was Jennifer able to recommend another vet perhaps? I do think you need some more diagnostics on this. And you need to have her on insulin. We are not vets here and insulin should be started under the supervision of a vet.

    Sending Skinky prayers and vines. Please keep us updated.
     
  13. skinky44

    skinky44 Member

    Joined:
    Dec 19, 2014
    Thanks Marje (and Gracie..) My home testing so far was low...218 and 250. I see the vet on Tuesday. Hoping for a stronger antibiotic. Not opposed to starting her on insulin...but now i'm more concerned about her labored breathing...

    I will keep you posted...
     
  14. skinky44

    skinky44 Member

    Joined:
    Dec 19, 2014
    Jennifer lives in the burbs...she was so super kind to schlep to the city...so I don't think whoever she uses for a vet would work for me...
    But I really don't want to get the CT scan, which is what the current vet is recommending...
     
  15. bettyandhank

    bettyandhank Well-Known Member

    Joined:
    Feb 21, 2010
    Maybe we can help you find a vet close by. Both Caryl and Hillary live near the city. Caryl works at a vet she mentioned on FB. it is not right in the city but may not be too far. OR perhaps he will know someone closer to you. I wonder if you can get in tomorrow somewhere. Your numbers are much better than before, not super high but not in 'normal' range either (50-120) So slightly elevated. You definitely want to try to see if you can get her eating, We have a million tricks around here, pour tuna juice on top, add a little moisture and microwave for a few seconds to get to mouse temperature. There is a probiotic called fortiflora you can get at vet, which also acts as a food enticer for many cats as it contains animal digest (the same enticer sprayed on dry cat food to make it palatable..you sprinkle on top of their food.
    Ask if there are any other diagnostic options that will confirm what skinky in fact has, but it may be CT is the best/only option. If it is NOT an infection and is something more serious, the sooner you know the better you can decide what to do for her. The insulin needs may only be due to whatever else may be going on. But if you can address those may make her more comfortable and avoid getting any worse in that dept.

    If you have reservations about this vet, and sounds like you do, it may be better time/$ spent to pursue another opinion tomorrow. We can try to get some members to hopefully refer someone for you. We have had many members in NYC, I cannot recall what part of town you are in. Maybe start another thread seeking vet in NYC- (add area). I would love for you to be able to get somewhere ASAP perhaps even tomorrow if possible. Lets all put feelers out and see what we can come up with

    ETA: was thinking even if you end up trying another vet for opinion, it may be if you DO the CT scan it may still be best/cheapest to have it done at the non profit place even if you have someone else interpret results or treat going forward.
     
    Last edited: Dec 28, 2014
  16. Marje and Gracie

    Marje and Gracie Well-Known Member

    Joined:
    May 30, 2010
    I definitely think a scan is not a bad idea. You need to know what you are dealing with or you could be throwing your money at the wrong treatment.
     
  17. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    I don't know where you live but if near Queens my friend has had good luck with BluePearl Veterinaary Partners. I hope you find a good vet, get some answers, and your kitty starts to recover from whatever this is.
     
  18. skinky44

    skinky44 Member

    Joined:
    Dec 19, 2014
    Thank you Tiffmaxee RE: the Queens vet. It's a bit of a haul (I travel via train) but I might ask depending on how things go tomorrow. :)
     
  19. Nancy and Scotty

    Nancy and Scotty Member

    Joined:
    Jul 13, 2014
    My niece's cat had a sinus infection with pretty much the same symptoms except for the swelling, after she has taken her to the vet several times with no luck I took her and insisted on a 6 week regimen of Zeniquin, this did clear it up, the reason I did this was because I have had severe sinus infections myself and know what it takes to clear them up, if that is her only problem it should work,I hope that it is and she does not have cancer.
     
    skinky44 likes this.
  20. Marje and Gracie

    Marje and Gracie Well-Known Member

    Joined:
    May 30, 2010
    Any updates?
     
    skinky44 likes this.
  21. skinky44

    skinky44 Member

    Joined:
    Dec 19, 2014
    Hi all,
    Turns out my vet appt is tomorrow, 1:15pm, not today.
    She is very loud, certainly with breathing - she is, at times "snorting". I think she might have fluid in her chest as well. Then there are periods when there is no "gurgling". Yesterday her bowel movements weren't so great and today has been even worse. Her appetite has significantly decreased. I've opened three different cans of food, she nibbles a bit, but mostly walks away from it. She is drinking water. I gave her some vaseline and just got some pumpkin for her, which she did eat. Got a vaporizer for her, soaked a cotton ball with eucalyptus oil and am boiling water in the apt, hoping this will help her breath. I also called the ASPCA to find out about prices, etc., and I might take her in there tomorrow depending on what the humane center doc says. The ASPCA has an oxygen room. They couldn't comment on cost though.
    She hid herself in the closet for a little while, poor thing, but now is back in her territory, our bed, looking a little out of it. My bed is 20 inches off the ground, although there is a loveseat next to it. So at least she is managing to move around without assistance. I will add Zeniquin to my list of possible drugs for the doctor. At this point, I'm wondering if a steroid should be administered? I believe that is frowned upon with diabetic cats, but I am more concerned about her breathing now...

    I should add - there's no snot/mucous coming out of her blocked nose. it almost seems like it's going into a pocket *beside* her nose...and I think this is what's causing the swelling in the left side of her face. Just another awful alternative. If a steroid or antibiotic can't fix this and it requires surgery..oy. I am going to ask about a nasal flush, and I'll see how much the xray is...although, again with the latter, if they do find something via xray, I still can't afford nasal surgery...and she is between 15 1/2 and 16, not sure if any type of surgery or chemo even makes sense even if I did have the funds.
    thoughts?
     
    Last edited: Dec 30, 2014
  22. Marje and Gracie

    Marje and Gracie Well-Known Member

    Joined:
    May 30, 2010
    Thank you for the update. I would be careful with the eucalyptus. Essential oils (and some nonessential oils) are toxic to cats even if just inhaled. Sending healing vines and prayers.
     
  23. skinky44

    skinky44 Member

    Joined:
    Dec 19, 2014
    I just took her BG - she is 304. her demeanor is just so bad...
    should I inject her??
     
  24. skinky44

    skinky44 Member

    Joined:
    Dec 19, 2014
    I just took this picture..and you can see a bit more clearly the swollen area around the bridge of her nose on her right side.
    Her BG from blood test 17 Doctor's on 12/17 was 363, this past Sat was 215, Sun was 250 and 304 just now. But I don't know how/if the diabetes/insulin levels are affecting her breathing..
     

    Attached Files:

  25. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    If she is over 200 mg/dl on a human glucometer she does need some insulin. If she is not eating, maybe half her regular dose.
    Reducing her glucose level some may help her to eat.
     
    Last edited: Dec 31, 2014
  26. skinky44

    skinky44 Member

    Joined:
    Dec 19, 2014
    I just tossed the cotton ball. I read somewhere to use that
     
  27. skinky44

    skinky44 Member

    Joined:
    Dec 19, 2014
    I've never given her insulin before, so she doesn't have a regular dose..
     
  28. Marje and Gracie

    Marje and Gracie Well-Known Member

    Joined:
    May 30, 2010
    I don't think the diabetes is affecting her BG. She needs insulin but you need to see the vet to get it started. Can you take her to the ER? I'm very worried about her breathing and the way she looks.
     
    Squeaky and KT (GA) likes this.
  29. Squeaky and KT (GA)

    Squeaky and KT (GA) Well-Known Member

    Joined:
    Jul 19, 2011
    I agree with people above, she really needs to see a vet quickly, I too am worried about her breathing and the way she looks. HUGS! This is SO hard on our human hearts...
     
  30. annie langevin

    annie langevin New Member

    Joined:
    Dec 31, 2014
    Poor angel. Good luck baby kitty<3
     
  31. Marje and Gracie

    Marje and Gracie Well-Known Member

    Joined:
    May 30, 2010
    How is Skinky?
     
  32. skinky44

    skinky44 Member

    Joined:
    Dec 19, 2014
    Hello all,

    I took my Skinky into the Vet yesterday, yet I"m no better off than before. He gave her another shot of convenia, prescribed Zenequin, and ordered a fructosamine. He did another quick BG reading, it was a little less than before, but still above 300. I think it was about 325. He is still not convinced that she has diabetes, thinking her BG might be elevated due to whatever it is that she is fighting, so he did not recommend insulin yet. But she is NOT doing good. I don't think he really knows what it is, not without further (expensive) diagnostics. He still suggests a CT scan, but thinks this could be anything from cancer, (I think he thinks a nose tumor), an abcessed tooth or something fungal. How a ct scan could help with something fungal is beyond me. He has suggested I go to a more full service hospital.

    She is doing very bad. I had hoped for a boost from the antibiotics, as they helped before. She has raspy breathing. When she purrs it breaks my heart coz she sounds SO bad. she is now constipated and barely eating. I'm going to try to bring her into yet a third vet tomorrow. I took a BG reading earlier and she read about 311 with the Relion.

    A couple of people suggested I do a crowd funder, which I did. It's here: http://www.youcaring.com/pet-expenses/sweetest-kitty-unknown-illness-needs-your-help-/285299

    I think my main thing for tomorrow is do I go to this vet who only deals with cats and was recommended by someone on the FB site, or a hospital. I'm going to try to call the recommended vet's office and see what they say. The last thing I want to do is pay an office visit and still be told they don't know anything and refer me to the hospital.

    The vet said she lost more weight too. The awful thing is the up and down, because initially the convenia injection was helping her and I thought she was going to get over this. Also, the humane society vet might have her fructosamine numbers in tomorrow (or Monday), but as others have mentioned, I guess at this point the diabetes is secondary. I did read somewhere that the Zenequin could decrease appetite and wonder if I should cease that.

    I'm very afraid for her.
     
  33. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    I'd be concerned about ketones with the high gluocose, infection, and not eating. Maybe get some KetoDiaStix to monitor the urine.
    With that high a level, a token dose (0.25-0.5 units) of insulin might help her feel better and perk up the appetite
     
  34. Marje and Gracie

    Marje and Gracie Well-Known Member

    Joined:
    May 30, 2010
    While I agree that Skinky needs insulin, I would not give it to her without a vet which means I would get her to another vet today, if at all possible.

    Here's the thing.....she has diabetes. Her BG will not be elevated due to what she is fighting unless she's diabetic. She might only need a short course of insulin, but she needs it. If she was dx on Dec 17th and she's been hyperglycemic since, then you should know the longer she is in that state, the more insulin resistant she may become. It's vital to get her to a vet who knows what he/she is doing and gets her started on insulin.

    Do you think she is suffering? I'm very concerned if she is constipated and not eating. I think this is an emergency situation for Skinky. I just ask that you please don't delay in getting her to someone who can properly dx and treat her or let you know that it might be time to help her cross.

    Sending many prayers.
     
  35. Ann & Scatcats

    Ann & Scatcats Well-Known Member

    Joined:
    Dec 31, 2009

    Laura, that was very helpful uploading the med tests

    I am on an Ipad and they open in ibooks which was hard to read it off in for me

    I noted a lot in the remarks and problems and combinations. I have to read it thourough again and get back with it
     
  36. Ann & Scatcats

    Ann & Scatcats Well-Known Member

    Joined:
    Dec 31, 2009

    Laura, now I've read off the test results

    There seems to be 2 things going on
    It's oncology internal

    1. AST, ALT, GGTP - are all liver values - 20,26,1 - all towards the very lower liver end - and Bilirubin also liver towards the very lower end - it is suspectible liverfailure
    which with also liver function related very high bloodglucose combined in that


    2. Tot Protein, Globulin, - towards the very highest end spikes
    Plus Leukopenia no Lymphocytes, super low - that is often direct rekated combination of blood/bonemarrow cancer multiple myeloma cancer, which includes growth in also lymph tissue lymphomas
    - Specific E-fores Proteins specifications blood test needed - it should show all these blood proteins separate in a complicated chart and which of them all exact spikes
    Needed to first determin right and for finding right type of treatment and protocol.

    The white bloodcells High Neutrophila in that picture is also a cancer type white blood cell indication, but only the combination the blood proteins and the Leukopeni super low Lymphocytes are enough for that.
    Plus the towards the very highest end spike Calcium.

    And then the Hemolysis 1+ in blood becomes very significant even if his remark judge it not, since spleen, blood bone marrow cancer and liver Hemolyses too in blood.

    Lethargy and super stone hard sleeping very hard to wake up is normal with if sucha type blood bone marrow cancer.


    I know he had suggested an internal vet but I say also an oncolog.
    Plus her blood pressures too.


    I have gone through this.


    I hope for you to read this and give your input, having Skinky there with you.
     
  37. skinky44

    skinky44 Member

    Joined:
    Dec 19, 2014
    Ann - thank you so much. That sounds awful!
    We spent most of the day at the low cost vet mobile. This vet, I thought, was very good. He gave her a B12 shot and some fluids, along with a bag of fluids to administer at home via IV. Unlike the other doctor, who is "not convinced" she is diabetic, this doctor believes that she is. He took a BG today and I think it was around 343. He said a CT scan would actually be 2k. I can't do the CT scan and not sure if it even makes sense, but I did ask about xrays. I am bringing her back tomorrow to be anesthetized and get a full body xray done. Tomorrow he will show me how to do the insulin as well.

    The insulin now is an issue for me due to the expenses of all of this. I had anticipated getting Lantus, but now think I might have to do Humulin N because of costs. I asked him about the Humulin N, as I hear it is much more harsh. He seems to feel that I should do the Humulin N for costs purposes, I think primarily because of her condition, he doesn't feel optimistic that she is going to be around much longer. we are going to discuss some pain meds for her tomorrow as well. I don't know if it doesn't necessarily matter at this point if it's Humulin N vs Lantus or if the Humulin N is going to cause her pain because it's stronger?? He is suggesting about 1 ml to start. I am also nervous about over dosing her with insulin. I'm also nervous about whether she's going to get through being anesthetized tomorrow. She is weak and dehydrated.

    If you think she has bone marrow cancer, are prospects terribly slim? How much time does a cat usually have? I am so sad for her. she looks even worse today..
     

    Attached Files:

  38. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Maybe ProZinc might be a reasonable compromise. You can adjust the dose as needed for fluctuations in glucose that happen with erratic appetite.

    Humulin/Novolin doesn't hurt the animal, it just has very steep drops and very steep wear offs in glucose control and only lasts 6-8 hours in the cat. If you can dose every 8 hours, it can be OK.

    I had a kitty with osteosarcoma, a bone cancer. The prognosis was about 6 months; we tried chemo and got 9, very expensive, months. And despite being told cats handle chemo well, she had vomiting and/or diarrhea after each treatment. (We thought we found it before it spread; we didn't.)
    The cancer metastasized to her kidneys and renal failure is what caused her death.
     
  39. skinky44

    skinky44 Member

    Joined:
    Dec 19, 2014
    Oh BJM, I am so sorry! I'm not sure if I can ever get another pet after this. Did you?
    I am overwhelmed.
    I sometimes have to travel out of state for my own medical treatment and I can keep an erratic schedule. I think 12 hours is better. I will ask the vet about prozinc tomorrow. I was able to sign up for a Lantus solo star card? and got approved. I don't really understand any of this too much and maybe I won't be able to use it in actuality. the vet was trying to steer me toward the pens...
     
  40. skinky44

    skinky44 Member

    Joined:
    Dec 19, 2014
    Hi Marje,

    I haven't deliberately been delaying, I think I just trusted the wrong person. On the 17th that doc didn't seem to want to start her on insulin and wanted me to strongly consider the CT scan. So I went to another vet two days later. Then back to the original vet on Wednesday for what i thought was going to be an insulin demonstration, but he said he STILL wasn't convinced that she was diabetic and ordered the fructosamine. I called his office (he's the dir. of the humane society in nyc) and the fructosamine results were in, but the front desk said the doctor had to call me with the results. And you know what? He still didn't call me with the results. Anyhow today I went to yet a different vet who has been the most helpful. And tomorrow I return to him for an insulin demo and the other things I mentioned in my post.

    As other more knowledgeable people have remarked on the FB page, why didn't this doctor order the fructosamine on the 17th? All I could do was trust him really.

    Do you think 1 unit of insulin is too high to start? Is it not better to start a bit lower? I am afraid of injecting her wtih too much. I believe her readings today (and she was extremely agitated, if that matters with her levels) was about 343 or so..

    I won't have the fructosamine results till monday now from the first vet. I am very upset with the humane society.
     
  41. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    I had several other cats at the same time who gave me a lot of comfort.

    Without a solid diagnosis, you don't really know what's going on although you have strong suspicions. The real question is how you want to manage it if is cancer. If you would choose comfort care, ie, palliative care, you don't really need the solid diagnosis, you need tools to manage the symptoms she is having and to make her comfortable and able to function. Insulin and prednisone are such tools for comfort care. Yes, the prednisone will raise the glucose; it also will maintain her appetite and reduce some symptoms.
     
    Last edited: Jan 4, 2015
  42. Ann & Scatcats

    Ann & Scatcats Well-Known Member

    Joined:
    Dec 31, 2009


    Laura, I am pleased you got a different vet this time. In regards to the more expensive CT, which can be used for cancer growth/mass screening, just matter of the so called specifity of all as CT, versus xray, versus MRI - and the The Ultrasound Scans. On my Simba and Gustav we only do Ultrasound in the internal oegan, abdomen, heart region. It is kitties, they are so body tiny that an Ultrasound for a good vet is easy.
    I also got called myself the past year for cancer screening, first in the xray machine, which was so unsure they called me in for the better see direct specifity Ultrasound.

    For Simba really ending up bad with his pancrea, swollen inflammed entire 1.5 centimeters, besides constant Ultrasound of entire Simba and Gustav after that, I also had them do Fine Needle biopsy under sedation, in both the swollen pancrea to get all different active cells going on in it.

    The same with Gustav and his blood bone marrow cancer as per se above, multiple myeloma, plasma cell cancer. Gustav was born with the Leukopenia of the Lymphocytes, and since I had them life long in once a year first for annual full blood tests and health exam, then twice a year after 2006 - I saw it early then with the other screaming indicator Tot Protein, spiking super high.
    Yet it was fluctating in beginning but by 2008 so much constant high Tot Protein and others related, I had them do this E-fores Blood Protein Specification blood test. I have it all on paper here (at home) showing what these specifications and spikes looks like.
    That vet however messed up too, didn't even get b a c k with a reply. So no treatment for it for Gustav.

    2009 went, and 2010 went. Then I had them do another E-fores specifying blood test of the protein spikes.
    That onco internal vet came back to me, and it was for him a rare type in cats, more common on dogs and with dogs higher survival 50/50 against cats survival only 20/70. I went for it anyway with Gustav. That was 2011 then. The Alkeran chemo tablets and the cortison tablets was cheap. I've enclosed picture of the Alkeran chemo tablets. Super tiny. And he didn't throw up or anything, but he got low white blood cells overall from it.

    Gustav's heart too went bad, Chamber Hypertrophia development and high blood pressure 240 Systolic, so also Fortekor and Norvasc tablets for that.
    A complication for him developed, simply with all his ordinary leg blood veins basically becoming unable to even touch with the mandatory every 3-4 internal blood test when on the chemo, they just burst and enormous hematom developed in them and his legs. And otherwordly pain for him from that. They burst him so well that it was unable to heal at home even before next time.
    I took him off the Alkeran then.
    And did every 6 months organ internal Ultrasound, and did one so close in time as in the fall 2011 and he then had none lymphoma growth internal too. But when he died 6 months after, he had a lymphoma growth. Either it was cell growing then 6 months before, not able to be seen as full mass yet, but was in growing into a clearly visually seen one only 6 months after.
    Blood in his urine in the last months too before he died.
    All horrible and I pretend it hasn't happened, but put in the perspective of already blood bone marrow cancer there visually in all blood tests in 2008 to 2011, totally untreated, I don't know what the first vet not getting back in spite real blood tests for it, would have said to me then in 2008, in terms of survival years in treatment.
    You see, Don't give up Hope

    Go to this new vet there with this specific tests for it, they are readily and almost direct available to the vets to quick draw these specific blood tests and Ultrasounds and use as and in the diagnostics.
    And they shouldn't really cost so much. Not in comparison to other things.


    Telepathic Simba always said to me - Listen To Your Heart and Don't Give Up Hope.
    And he was right 1 000 000 % aaaall the times. For 17 years.


    Listen to the above specific, listen to yourself - and Listen To Skinky
    And Tiger Mum right diagnistic tools harass the vet -:)


    You are doing Great, Laura. I am mighty proud of you already on top of it with help here, from Jennifer with helping with the home blood test know how show how, travelling around entire to me h u g e million people large New York for Skinky and yourself - you are One Of A Kind Of Hulluva Good Tiger Mama -:)

    Hugs to you both and May The Force be With You!
     

    Attached Files:

  43. Marje and Gracie

    Marje and Gracie Well-Known Member

    Joined:
    May 30, 2010
    Hi Laura

    I was off the board yesterday but wondering how Skinky is today? Did you start her on insulin? I'm only asking because her condition seems to have really deteriorated and unless she has done a big turnaround and you think she will be ok, then you will need to weigh whether to start insulin or not. In other words, if you think it's possible she may need to cross soon, then I wouldn't throw another thing at her, IMHO.
     
  44. skinky44

    skinky44 Member

    Joined:
    Dec 19, 2014
    I"m awful with this. I just freaked out and posted on the FB page. (I find this site a little tricky to use...i'm sure it's my inexperience).

    last night she was at 304 and i gave her some insulin and it did wonders for her. big time! she was eating, she pooped in the morning. I thought the swelling went down. tonight, I think the swelling is up and she hasn't pooped again and she is back to not wanting to eat. if is spoon feed her or feed her from my hand i might be able to get her to eat 1/4 of a can.
    these are her readings the last 24 hours. I know i'm a little random w/ when i take them.
    304 1/5 5 am
    249 1/5 724 am
    183 1/5 1123 am
    268 1/5 525 pm
    349 1/5 844 pm
    194 1/5 1112 pm
    74 1/6 253 am
    81 1/6 310 am

    i gave her some insulin, a small amount, but i'm not yet very good with this, when she read 349. vet said to make sure i get a 1/2 can in her before insulin, but that's impossible. when i tested her and got 74 i freaked and gave her maple syrup. I really freaked a few minutes later as her head seemed SO heavy, i thought I killed her. I wasn't sure though if the toradol pain med was making her this way, although this seemed a little exceptional. i posted my panic attack on FB and got a little guidance. I got some morsels of grilled pate down her throat and then brought her outside to the patio in the building and she walked around a little bit. i'm going to test her in a little bit. i totally suck at this.

    I don't know if she's going to cross or not. when she seems a little better i get so hopeful. I'm trying to use up the ten days of AB and fluids i have and see where she is at and make a decision then...
     
  45. skinky44

    skinky44 Member

    Joined:
    Dec 19, 2014
    Tested just now and got 105. Relief.
     
  46. skinky44

    skinky44 Member

    Joined:
    Dec 19, 2014
    Hi, i'm not very good with this board, so i'm sorry for my delayed and sporadic responses...
    the ct scan is 2k. I just can't swing that. I have been now to three vets...I liked the last one the best, and i've seen him twice. He gave her a B12 shot and some SubQ fluids. We were going to do a full body xray and send it out to a specialist, but when i came back the next day, she looked worse than the day before. It didn't seem worth it to anesthetize her for a possibility of a little light. He thought, at her age and with her multitude of things going on (emaciation, dehydration, diabetes and possible cancer) that it would not be worth it to do a CT scan even if it was an option as the treatment would be difficult for her to handle...

    so, he gave me Climacylin and toradol for pain...

    I did call caryl's vet and they weren't able to get me in until a few days later. i then explained the situation, results/tests and asked if she thought he would be able to treat her or if he would send her to another full service place and she the office manager thought he would probably send us to Blue Pearl or Animal Hospital, both of which are fairly pricy.

    The vet that i liked thought she was def diabetic, where as the humane society director is STILL on the fence. I still can't get my fructosamine results and they were taken on Wednesday, new years even. he called to say they were elevated and that he STILL wasn't convinced she was diabetic. I'm trying to find out the specific numbers. the vet i liked thought she was diabetic and that i should inject her with 1 unit once every 24 hours after feeding her at least 1/2 can. this, only if she tests 250 or higher. if less than 250, skip the insulin...
     
  47. Marje and Gracie

    Marje and Gracie Well-Known Member

    Joined:
    May 30, 2010
    I would call the humane society vet and tell him you paid for the labs and you want a full copy of the results including the fruc test. If he refuses, call the director of the HS. If they refuse, tell them you will call the State veterinary licensing board. They should fax you the results of all labs you paid for.

    Here is what worries me......that she will get hepatic lipidosis from not eating. That she can possibly go into diabetic ketoacidosis which is life threatening if she has infection, not enough insulin, and not enough food/water. But you have a catch 22 because she must eat if you are going to give her Humulin N. You did the right thing by giving her syrup when she came down. She is likely coming down like that because she has no food on board.

    Humulin N is roughly in the system 6 hours but could vary a little. I'd be sure I test her during that time, as you have been, to make sure she doesn't go too low. I would also call the vet and ask him if perhaps you could give her 0.5u every 12 hours if you are able to stay up and monitor her at night during the time the insulin is most active.

    One thing that would help us here is if you test her before you give the shot and that would either be her AM preshot (PS) for a morning shot or PMPS for evening so one hour after the shot is +1, three hours after is +3, etc. then you can report it to us like that since we are all in different time zones. That helps us see when the insulin is most active.
     
  48. skinky44

    skinky44 Member

    Joined:
    Dec 19, 2014
    thanks marje. fructosamine is 534, range is 142 - 450 and the page says that 500 - 614 is fair regulation. humane society doctor says he is still not convinced that she is diabetic. i asked the staff member for a app stimulant, but then i got disconnected. i still have no script for insulin, but i guess i can get humuln n w/o script..

    what do you make of these numbers? def diabetic? or not?
     
  49. Marje and Gracie

    Marje and Gracie Well-Known Member

    Joined:
    May 30, 2010
    I thought the third doctor that you liked put her on Humulin N?

    My suggestion is to take or fax the labs to the third vet that you liked and discuss it with him. A fruc test is just an average but you've been getting real time data showing her BG is high. I don't know if you need a script in your state for "N". In mine, you don't, but you should be giving it under the supervision of a vet.
     
  50. skinky44

    skinky44 Member

    Joined:
    Dec 19, 2014
    the third vet told me to use the lantus that jennifer gave me and if i wanted a script for lantus he would call it in or i can get the humulin N w/o script.
    can you administer insulin on an empty stomach? she just won't eat. the best i can do is stand up with food in my hand and sometimes she will take some morels, if i'm lucky. i've tried syringe feeding her and it just isn't working. she'll eat a little yogurt.
    today i noticed she has some sort of longitudinal wound, like a wound w/in a wound. almost vaginal like. only pink, no red. no hair around it. it is under her jaw.

    i think we are at the end here. i don't think my surgery went very well, this is certainly complicating it, and I have to start traveling again for second opinions for a surgical re-do. the vet i liked is pretty much an all excursion, unless it's fri or sat. in any event, we wait in the cold to see him, and I don't think that is helpful. phone tag with humane society doctor, it's awful trying to communicate with him. i'm sure if i bring her in for this jaw issue, he will, like other times, tell me to go to the animal hospital nyc and get a ct scan.

    what kills me most is that she won't eat. I asked both vets for scripts for appetite stimulants.

    vet said to give insulin after feeding her a half can. WHAT IF I CAN"T??

    she's absolutely miserable and i'm beginning to think that i'm being cruel. she will eat yogurt, just a little and i try mixing it with food, but that doesn't always work.

    these are her numbers that i've been keeping...

    250 12/28 7 pm

    304 12/30 11:30 pm

    164 1/3 6:30 pm

    202 1/4 4:30 am

    304 1/5 5 am

    311 1/5 4:40 am - administered insulin

    249 1/5 724 am

    183 1/5 1123 am

    268 1/5 525 pm

    349 1/5 844 pm -- administered insulin

    194 1/5 1112 pm

    74 1/6 253 am

    81 1/6 305 am

    105 1/6 343 am

    113 1/6 433 am

    as i mentioned, for some reason the humane society doc still isn't convinced that she is diabetic. I will start making notes of my insulin injections. doc from vet mobile advised 1 unit every 24 hours after a half can feeding only if her bg is above 250. I'm a little unclear still about what i'm administering - i know i know. but i would say i was being overly cautious and aiming for 1/2 unit when i administered the injections
     
  51. Marje and Gracie

    Marje and Gracie Well-Known Member

    Joined:
    May 30, 2010
    I wouldn't give her the N without her eating...you could be fighting low numbers.

    I don't k ow, Laura....from your descriptions, it does sound like she is suffering. Starving is no way to go. Have you tried baby foods with nothing but the meat and/or just water...no broth, no cornstarch, no onion or garlic?

    Of course, you know her best and none of us can see her but your descriptions break my heart.
     
  52. skinky44

    skinky44 Member

    Joined:
    Dec 19, 2014
    oh - the third vet's admin asst (i don't know how this place has these things set up since they're mobile, i think the admin office is off site somewhere) called and told me that based on the fruc levels she IS diabetic (strange how two docs can be so different about whether she is diabetic or not, huh?). I asked her to ask the doc to call the insulin into the cvs pharmacy. it is from the THIRD vet that I got a copy of the fruc test which the humane society doc took. god only knows when I'll get the hard copy of the fruc test from the humane society..
     
  53. skinky44

    skinky44 Member

    Joined:
    Dec 19, 2014
    she seems to like fage yogurt...sometimes she'll eat a little duck. she has only eaten half of one of those small cans today, and with great effort. what is the least amount of food you can give and administer insulin? i hope she can last in time for the app stimulant script...
     
  54. Marje and Gracie

    Marje and Gracie Well-Known Member

    Joined:
    May 30, 2010
    It depends on the cat, their insulin sensitivity, the insulin, etc so I don't know.

    Sending many prayers.
     
  55. skinky44

    skinky44 Member

    Joined:
    Dec 19, 2014
    thank you
     
  56. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    When the glucose is high (over 300 mg/dL on a human glucometer), there may be no appetite, especially if fat is being broken down for calories. Plus, the cat may not feel very well. Giving a token dose (0.25 - 0.5 units) of insulin may drop the glucose enough for it to trigger some hunger. Since you are testing, you can monitor how much of a drop you get, as well as behavior, to see how it is working.

    Fat breakdown generates ketones. Too many ketones may result in diabetic ketoacidosis, a potentially fatal complication of diabetes and expensive to treat. Also, the fat goes to the liver to be processed; if too much fat goes to the liver at once, the cat may develop a condition called hepatic lipidosis (basically fat in the liver), which disrupts normal digestion. That, too, can be potentially fatal and expensive to treat. If the cat has not eaten in 2 or more days, the risk of hepatic lipidosis increases.
     
  57. skinky44

    skinky44 Member

    Joined:
    Dec 19, 2014

    can i give a drop of insulin (.5 or less) to her on an empty stomach? she just won't eat...syringe feeding is not working...she will take a couple of licks of fage yogurt, that's it. i try to put the yogurt around some food but she won't take it.

    it's sad coz when she hears the can open, she perks up and she stays in the kitchen area where I feed her, but she won't eat ANYTHING i give her..
     
  58. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    As long as you are monitoring the levels and they are high, yes.

    The insulin goes into the blood stream, not the stomach.
     
  59. skinky44

    skinky44 Member

    Joined:
    Dec 19, 2014
    what is considered high when administering on an empty stomach?
     
  60. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    I've just been reading through Skinky's thread. I can't suggest much, but my cat had major problems with appetite loss during a pancreatitis flare. It's agony to go through, and my heart goes out to you. :bighug:

    I note that Skinky still seems interested in food, perking up when she hears the can open but she just doesn't want the food. Is she showing any symptoms of nausea, by any chance (e.g. pulling faces or lip licking after food, licking some food then leaving it - there's a good symptom checker from Tanya's Site here). If she is then Cerenia or GENERIC ondansetron (for price - Zofran (branded version) is obscenely expensive) alongside the appy stimulant can really help. Have you managed to get the appy stimulant yet? If not, then if possible raise merry hell till you get one. The appy stimulant made an immediate difference for Saoirse - she started eating very shortly after the first dose was adminisitered. A tiny, tiny dose of Cyproheptadine was enough to get her eating for several hours. If Skinky is queasy, then anti-nausea meds would help both with symptoms and also with prevention of food aversions.

    The only other thing I can think of is maybe because of her sinuses she can't smell/taste the food properly. Things that can help are to put something pungent on the food (e.g. tuna water, parmesan cheese, Fortiflora) and / or to warm the food up a bit so that it releases more aroma. I'm sorry if I'm suggesting things you've already tried. I just want so badly to try to do something to help you and Skinky.

    I don't have enough experience to suggest anything about insulin dosages.

    I hope that you can get Skinky to start eating very soon. In addition to providing nourishment, it will make insulin treatment more straightforward. I'm going to keep you both foremost in my prayers. ((((Skinky and Mom))))
     
    Last edited: Jan 8, 2015
    skinky44 likes this.
  61. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    If she's over 300 mg/dL, she's above the renal threshold and then some. I'd give at least a token dose to get it down. Some vets, when they have you fast a diabetic, ask you to give half the normal dose of insulin.
     
  62. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Thinking of you and Skinky, and keeping you both in my prayers. :bighug:
     
    skinky44 likes this.
  63. skinky44

    skinky44 Member

    Joined:
    Dec 19, 2014

    Hi critter mom. Nope, no nausea. no app stim yet, hopefully script comes in the mail. dealing with humane society of nyc and it is IMPOSSIBLE to get them on the phone. i left a psycho screaming message the other day. it is not unusual to be on hold for 20 minutes just until you get the front desk person. i'm not very mobile, am recovering from a leg surgery, so i have to choose wisely my excursions. anyhow, it probably is a nasal tumor. it seemed to drain a little today and i have her in the "kitty sauna" (the bathroom with hot water going) to try to loosen the crud under her nostril. it seems liek the bridge of her nostril is draining too. i don't know if this is good or not. it is tinged with blood. i got some syringe food into her last night and earlier today. how many syringes does she need? so little goes into these tubes and my goodness does she hate it.

    hopefully the app stim comes today. but I still don't know if i'm being cruel and selfish by not bringing her in for a permanent sleep.
     
  64. Squeaky and KT (GA)

    Squeaky and KT (GA) Well-Known Member

    Joined:
    Jul 19, 2011
    5cc's is a teaspoon so keep it going, she needs as many teaspoons as possible. It's new to her, she'll do better the more you feed her that way. Sometimes it would help KT start eating by himself.

    HUGS
     
    skinky44 likes this.
  65. skinky44

    skinky44 Member

    Joined:
    Dec 19, 2014
    hi, well i don't know. humane society director said he is STILL not convinced she is diabetic. did i post the fruc results? he still thinks that she might be elevated due to the infection/cancer.
    2nd and 3rd vet thinks she is diabetic. 3rd vet said insulin 1 unit every 24 hours after she gets a half can into her (impossible) and if she tests below 250, NO insulin.
    When I called his manager for some scripts the manager reviewed her records and said i must've misunderstood him, that she should STILL get insulin EVEN if she is below 250. My head spins.
    Thank you yes i've been told that might kickstart her appetite. hoping for the best! thanks!!
     
  66. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    My vet had me fast a cat pre-dental and give 1/2 of the regular insulin dose, so it can be safe to do when he isn't eating (much). His glucose was up over 200 mg/dL and he was on Lantus at the time.
     
    skinky44 likes this.
  67. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Hi Skinky's mom,

    I've been praying for you both all day. I'm very sorry to hear the run-around that you're getting from the humane society: you have more than enough to contend with caring for your little one without all that on top. I hope the appy stimulant Rx comes today, too. I'm relieved to read that you managed to get Skinky to eat a little bit for you last night and this morning. Keeping fingers and paws crossed that it may kick-start her appetite. I have no experience with things like the nasal draining, but maybe the reduction in pressure might make Skinky feel a bit better? I really hope so. I'll continue to keep you both in my prayers. Sending healing vibes to your little one across the waves, (((Skinky))) and a hug for you. :bighug: I've just read Skinky's story on your link above. I see she's a fighter. :)
     
    Last edited: Jan 8, 2015
    skinky44 likes this.
  68. Marje and Gracie

    Marje and Gracie Well-Known Member

    Joined:
    May 30, 2010
    I wonder if you also hold warm compresses to her nose area if that would help?

    If you can find any Iams Max Calorie food, it is good for assist feeding and has tons of calories and is low carb. It is prescription but maybe vet 2 0r 3 could write the script and you could ask on doc them about the appy stimulant?

    Here is a really good video on how to assist feed a cst:

     
    skinky44 likes this.
  69. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Good morning, Skinky's mom. Checking in to see how you're both doing. Did your girl manage to eat a little for you? Did the appy stimulant get to you yet? I really hope so. It helps their recovery so much when they manage to get some food into them.

    Skinky is so brave, and she has really touched my heart. Praying for you both.

    (((Skinky and Mom)))
     
    skinky44 likes this.
  70. skinky44

    skinky44 Member

    Joined:
    Dec 19, 2014
    hi critter mom,
    I FINALLY got the app stim today. After several phone calls I demanded that they call the script into the pharmacy. I was actually in tears when i went to the pharmacy and they said they didn't have it and i called the inhumane society (it's only the one in nyc which is inhumane) and they insisted they called it in and then put me on hold for close to 15 minutes...i finally asked AGAIN at the cvs pharmacy and it WAS called in, under Skinky's name. Skinky Cowan. Ok. Would've been nice is someone would've mentioned that so I wouldn't have literally bawled my eyes out in the store. SO...administered half pill of the cyprohep pill....she seems to confused, like she wants food, but hasn't eaten yet. she DID drink a little water, which was great, because she stopped that as well. I got one syringe into ther this morning, which as you know, isn't a lot. about 2 teaspoons. last night I got 4 syringes into her, but between the syringes, the B checking, the IV, the four pills, i think she hates me. I am going to stop monitoring the diabetes for a while, all of the poking and probing and sticking is really upsetting her. Last night she started having a lot of saliva come out of her after i administered the SubQ. She is very weak, but still holding on. I just hope this app stim works and then i can evaluate other issues. it's only been about an hour or so. I will keep you all posted! :) Thx critter mom, she really is such a super sweet kitty. Jenn says she is surprised at how scrappy skinky is.


    So...
     
  71. skinky44

    skinky44 Member

    Joined:
    Dec 19, 2014
    Hi Marje, that is a great video, I think I had seen that. I watched a few on Youtube. all i can say, is where do they find these cats? as weak as my girl is, she can still manage to pull a houdini out of the towel. and i clip it with binder clippings too. I will see if my local petsmart has that Iams. Any one have any idea about how long i should give this pill before i should maybe switch to the other one? Or make a different decision about her. I can't keep watching her waste away...
     
  72. skinky44

    skinky44 Member

    Joined:
    Dec 19, 2014
    Oh marje - yes - I put her in the kitty sauna (bathroom w/ hot water running) for a a little while each day. i put vaseline along the crunches around her nose and the steam helps to loosen them up. her nose is very sensitive, but i'm hoping if i can keep the crunchies away it will less inhibit her smell and in turn help her appetite. as she allows it, I do try to place warm compresses to her nose, but it is quite sensitive for her..
     
  73. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Hi Skinky's Mom,

    I am very relieved to hear that you finally got the appy stimulant. I'm hacked off that you had to go through the ringer to get it for her. Well done you for getting round the human obstacle course. And well done Skinky for eating and drinking a little bit for your mommy!

    Cypro is relatively gentle in its action but it can cause sedation at quite low doses (it's an antihistamine), so Skinky might get a bit groggy. With Saoirse, the cypro usually started to work within 1-2 hours (her weight's between 9-10lb, tablets were 4mg and about 1/8 of a tablet was the dose she usually needed, sometimes even less). Depending on how she was doing on a particular day, the effects could last anywhere from 8 to 24+ hours. In consultation with my vet, we decided that ad hoc dosing would work for her. I used to log the time I gave her the dose and wait for her appetite to peter out. If that time was greater than 8 hours, I'd give her the next dose. If it was less than 8 hours since the previous dose, I'd wait until 8 hours elapsed and then give the next dose.

    I know it can be really tough having to poke, prod and pill our little ones round the clock - on both kitty and caregiver - but horrible as it is, it can work wonders. At one stage Saoirse was on Lantus/Pro-Kolin/Famotidine/Ondansetron/Cyproheptadine/Stomorygyl (2 tablets) - all BID, plus BG testing and once an hour microfeeds. Several weeks of diarrhoea and loose stools didn't help at all. She was very poorly before the appy stimulant and anti-nausea med started helping and wasn't a happy kitty at all with getting the shed load of meds , but I gritted my teeth, apologised to her (a lot), gave her lots of reassurance and praise and battled it out. It was that or lose her. Thankfully she started to rally once her food and fluid intake improved. Slowly but surely she improved and a few weeks later you wouldn't believe she' been so unwell. (Member Tisha's Person went through similar with her little one, and Tisha recovered really well, too, after starting to eat again.) Sometimes being a kitty mom is really tough, but it's always worthwhile. :) Give the cypro a while to help her get back to regular eating (even if you need to assist at times). It can take a few days to find the right dose. It's amazing the difference it can make when they start getting some nutritients back on board. :)

    I note that Skinky hadn't been drinking much before getting her cypro today. That's great news. Are you still giving Skinky sub-q fluids? And has the swelling gone down any after her kitty sauna yesterday?

    (((Skinky and Mom)))


    ETA: Improved nutritional support will hopefully stabilise Skinky and help her build herself up again while you bottom out a way to help treat the swelling. Please give some very, very gentle fusses to your plucky girl from me. You'll both stay in my prayers.
     
    Last edited: Jan 9, 2015
  74. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    I'm glad you mentioned the above. Offline, I've been wondering whether pain from the pressure of the fluids in the swollen area is a factor in Skinky's reluctance to eat? I had a dental abscess once and that hurt like there was no tomorrow before it was drained. I wasn't interested in food, either.
     
    Last edited: Jan 9, 2015
  75. Ella & Rusty & Stu(GA)

    Ella & Rusty & Stu(GA) Well-Known Member

    Joined:
    Jan 11, 2010
    Hi Skinky's Mom,
    I've been following your posts for several days and just wanted to tell you what a good job you are doing under the most difficult circumstances.
    I no longer live in NYC, but I thought you might appreciate a list of vet practices and clinics in the city that are highly recommended by Dr. Mark E. Peterson, the foremost expert on feline endocrinology and a pioneer in feline diabetes. I realize that hyperthyroidism is not one of your concerns, and you should know that Dr. Peterson is a specialist and I don't think he has a general vet practice. But I was most impressed with him when we brought our previous diabetic cat, Stu, to him to have him evaluated for the radio-iodine hyperT procedure. This link is from Dr. Peterson's web page. You might consider making an appointment with one of the vet practices listed. I would trust any vet practice that Dr. Peterson recommended.
    http://www.animalendocrine.com/about-the-clinic/recommended-veterinarians/
    When we lived in Brooklyn we took Stu to Animal-Kind in Park Slope (on the list).
    Good luck. I hope you can find a vet who will be able to help Skinky.

    Ella & Rusty
     
    skinky44 and Critter Mom like this.
  76. Marje and Gracie

    Marje and Gracie Well-Known Member

    Joined:
    May 30, 2010
    Laura

    I'm hoping the Cypro is working and Skinky can and will eat some. Sending many prayers for your fighter girl.
     
    skinky44 likes this.
  77. skinky44

    skinky44 Member

    Joined:
    Dec 19, 2014
    Hello Aine, Ella and Marje,

    Ella: Thank you for the list! It helps to narrow potential new vets down. I don't think I'll be engaging with a new one unless I can see some type of improvement with my girl. And I'm not sure, if she doesn't make it, if I ever want another pet again. I'll probably feel differently at one point. In any event I DO appreciate the list! :)

    I'm distressed over Skinky's reaction to the drug so far. The pills are 4 mg, and 'm to give her 1/2 pill twice a day. I gave her half around 6 pm EST, so about 5 1/2 hours ago. She DID take a few sips of water, but that was it. She seems VERY interested in food, but just won't eat it. It kills me because she keeps hanging out in the feeding area, following me when i'm at the fridge. but she won't eat. and then she cries, which she wasn't doing before. i think she cries because she wants to eat, but i don't know why she won't. again, fage, she'll eat a couple of licks of, but nothing else, even if I cover some salmon pate with the fage. But why is she crying like she wants to eat? i try spoon feeding her, putting some on my finger. i have small little plates with different varieties scattered about. i bring food to the bed, to the chair, keep it in the regular place. she has had a total of about 2 1/2 syringes today. it's just not enough to stave off lipodis/liver failure. i cuddle with her, because i still think she is a little traumatized from all the poking/prodding from yesterday. I keep thinking she's just not going to last another day if she doesn't really chow down...or she will have irreversible damage (if she doesn't already) if she doesn't start eating soon. Aine, as you say, my hope has been that once she starts eating I can really oomph up the food with vitamins etc. I already put llysine and b12 in the syringes. Now when I syringe feed her she is grinding her teeth. She is still walking fine, mostly (unbelievably!) She went into the hallway of the apt complex where i live and was very curious and i was impressed at how quickly she was moving given her absent nutritional intake.

    As for the nose...all three vets seem to think that she has nasal cancer. the swelling has not subsided. I do think it's affecting her appetite. she turns her head to the side, to the good nostril when i'm holding a morsel in front of her and you can hear her audibly inhale the food. but she actually turns her head the other way. have tried salmon, duck, mixed grill. these are all dishes she once liked - she was NEVER picky before.

    Is she telling me that she has had enough and wants to leave? It seems that with most people this app stim works pretty quickly...I think this is the best i'm going to get from it from here..
     
  78. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    From what you've posted above, it sounds like the cypro could be working OK because she's looking for food and vocalising. Saoirse normally has a silent miaow, but she got very vocal - unprecedentedly so - when she was waiting to be fed when the cypro was active in her system. Skinky's behaviour sounds very similar. From what you write it sounds like her appetite has picked up with the cypro but she's still having difficulty with the food itself. I really feel for you because I was frantic when Saoirse wouldn't / couldn't eat (I had previously lost a cat to HL and inadequate veterinary care). I note that Skinky's trying to smell the food with her good nostril. Have you tried warming the food a little? Or maybe putting something strong-smelling into it - something like parmesan or the water from a can of human tuna? Maybe you could try watering down some of the food - maybe put it in a food processor or blender if you have one to make it a bit soupy and then sprinkle some parmesan or add some tuna water to it. I didn't get to the syringe feeding stage with Saoirse, but when she was at her worst before getting the cypro the only way I could get any food into her was to keep dipping my fingers into some soupy food and letting her lick it off my fingers a tiny bit at a time. The other option would be to go with something really bland. That helped Saoirse, but she was nauseated at the time. Basically I poached chicken breast in some water, then blitzed up the chicken breast with some of the poaching broth to make a food with a soupy consistency and let her lick that off my fingers initially.

    Is there any chance of you being able to speak with one of the better vets you've been seeing about Skinky to see if the problem might be pain (or nausea maybe?), and whether they could give Skinky something to ease the pain and help her to eat something?

    I wish there was something more I could do to help you both. I hope that other FDMB members will be able to come up with further suggestions for you.

    Keeping you both in my thoughts and prayers. (((Skinky and Mom)))
     
  79. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Or maybe ask the vet about more antibiotics? In your opening post you mentioned that Convenia had helped before to reduce the nasal swelling?
     
  80. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    I've posted a link to this thread on the main FDMB Health board. I am hoping that other members with experience of syringe feeding, etc., might be able to offer more and better suggestions about how to help Skinky to eat.
     
    skinky44 likes this.
  81. skinky44

    skinky44 Member

    Joined:
    Dec 19, 2014
    Hi Critter Mom,
    Or Aine. :)

    I tried a lot of that...i have not tried parm cheese nor have i boiled chicken. you know i did try twice to get baby food, specifically chicken in broth. freaking had everything but. all this exotic stuff but not chicken and broth.

    I'm on my way out to drug store to either get a can of tuna or a small fancy feast for her. I noticed her bad nostril had some snot coming out of it - i interpret as a good sign, so i just finished giving her another sauna and putting vaseline around the blocked nose and trying to get the crusties out. perhaps i'm deluding myself. i just feel that if i can get her to eat and then get the nose to drain....but chances are she does have the nasal cancer.

    as for the vets. don't get me started. the two good ones are at this vet mobile, but physically it's a little tough for me to get there. they will give me some prednisone for her w/o a wait if i schlep up there tomorrow. i do not want to take her in to see them again, although I do think they are decent. there is no waiting area and last time i had to wait outside for three hours - quite cold. i just feel in her condition this is a little harsh for her. the inhumane society, is very difficult. apparently i can only deal with the doctor i've been dealing with, and he won't be in until monday. i might have mentioned that even another doctor could not give me skinky's fructosamine results. and they don't take walk ins. other vets are 90 to 195 just for a walk in and i've actually spent about 700 so far...i'm certain they will want to do additional diagnostics, perhaps understandably. One person (including the initial vet) suggested it might be fungus related. she developed a "hot spot" on her chin. I put a small amount of antifungal cream on her nose pores and on the hotspot. the vet mobile is not awful, it's just a little unusual. the man who owns or who established it IS fairly accessible (heck i've gotten the med documents for skinky that the inhumane society was able to fax to another vet (but NOT her mom) from THEM and not from the Inhuman Society). Anyhow, the vet mobile owner gives some advice about issues and meds...although he is not a doc. still they have been better than the IS.

    One tidbit I got from the FB feline diabetes board is that her stomach might be upset. she IS smacking her lips, and people have suggested that she might be nautious...so i have given her the recommended dose of peptic AC. I gave her a pain med as well. so now, with her nose cleared and hopefully with the peptic working, i'm off to try another , diff. type of cat food.

    poor thing. i don't know what more i can do for her. if she eats tonight, i will update. else I might eventually sleep...

    thank you for your concern. :)
     
  82. skinky44

    skinky44 Member

    Joined:
    Dec 19, 2014
    thank you. i'm concerned about her grinding her teeth. i'm also wondering if this is psychological. either from her being fed up and ticked off...or, they say if it is nasal cancer, that eventually it travels to the brain..

    the grinding is disturbing. it continues even after i've removed the syringe for a bit..

    i got a b12 shot for her last week and that did boost her appetite immediately. i wonder if i can duplicate that somehow myself, otc? in her condition, i am not going to wait outside in the cold for the van for a few hours. she wouldn't be able to handle it.
     
  83. Marje and Gracie

    Marje and Gracie Well-Known Member

    Joined:
    May 30, 2010
    Grinding can also be due to nausea.

    Sending more prayers she will eat tonight.
     
  84. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    I wish you had better veterinary support. :( A stint out in the cold like that wouldn't be good for either of you. (((Skinky's Mom)))

    I mentioned the nausea because Skinky had been sniffing food and turning away from it, and also licking some food and then stopping. Here's a good symptom checker for nausea from Tanya's site. It also goes through treatments. Saoirse needed both the generic ondansetron for nausea and the cypro to get her eating properly. Neither of them worked as well on their own for her. It does say on Tanya's site that slippery elm can help with nausea symptoms but I have no experience with it. From what I've read about it, you do need to give other meds at a different time because the slippery elm can affect absorption of other medicines.

    @Marje and Gracie - do you know whether slippery elm might help Skinky if she's nauseated? If it could, where might Skinky's mom be able to get some? I am thinking it could be a help if it proved difficult to secure an Rx for anti-nausea meds for Skinky.
     
    Last edited: Jan 10, 2015
    skinky44 likes this.
  85. phlika29

    phlika29 Well-Known Member

    Joined:
    Sep 14, 2014
    Over on the pancreatitis yahoo group the advice is that you should not give an appetite stimulant without anti nausea medication as it can great aversions to food. From the symptoms you describe it sounds just like my cat remi when he was nauseous. The lip smacking and walking away from food,etc. she may want to eat but then feels sick when you give it to her.

    My advice would be to speak to your vet about ondansetron or cerenia to add in with the other medication. If you describe what is happening I am sure they will understand.
     
    skinky44 likes this.
  86. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Has Skinky managed to poop yet? You mentioned earlier that she had been constipated. That can cause tummy upsets as well.
     
  87. skinky44

    skinky44 Member

    Joined:
    Dec 19, 2014
    she hasn't pooped today. I think it was yesterday that she had a small poop. a week or two ago vet #1 said she had air in her stomach.

    I just got some beef fancy feast, something new for her, and she comes out all alert when i open the can...but then nothing. I syringed some into her, i'm trying to do the syringing more frequently and with a little less food. i don't know if i can get the ondansetron or cerenia tomorrow from the vet mobile or not. they can be limited with what they carry. else i won't be able to get a script for it till Monday if i'm very lucky...and it's just too long for her to go without it. if this is common knowledge, again, i'm upset that the director from the HS didn't suggest it. argh. i know her creatine levels are not very high, 1.3. for the rest of the nausea causes, could be several. antibiotics, sub Qs, constipation..
     
  88. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    @Sarah, have you got any tips on giving fluids via syringe? I know you've posted about them before but I can't remember the technique you use. Also, what's the name of the easily digestible food that you used to give Remi (the one you mix up with water IIRC)?
     
    Last edited: Jan 10, 2015
  89. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    I can really relate to how frustrated you are with the lack of proper veterinary support - I've had similar experiences and I felt angry and powerless. Not good. :(

    It might be a good idea to log the times that she poops and how much she produces so you can keep track. I did that with Saoirse. It was very helpful to have some idea of what was going on with her digestive transit.

    The more you describe how Skinky is behaving, the more it sounds like nausea. I found it helped Saoirse to feed her tiny amounts very often. I started her on the poached chicken at our vet's suggestion because it is bland and easy to digest. (We have a good vet, thank goodness). I either chopped the cooked chicken up finely or minced it in a food processor and gave her about a tablespoonful of meat with 1 tbsp broth and 1 tbsp water every hour or so. It was the only thing she'd touch for me at the time.

    Is there anywhere that you could get freeze-dried treats? There were times when Saoirse just wouldn't eat anything, but she would take a few of those treats. Lots of cats find them really tempting. I call them Kitty Saltines, because Saoirse could always tolerate them even when she was very queasy. I'm wondering whether, if you got some, you might be able to crush some up or blitz them in a processor or blender so that Skinky could just lick them and swallow them - no need to chew - and then follow up by giving her a good drink of water from her syringe to help wash them down? It might be a way to keep getting some calories on board for the time being.
     
  90. phlika29

    phlika29 Well-Known Member

    Joined:
    Sep 14, 2014
    I must admit I found syringe feeding quite hard. You need to get it very liquid and very smooth otherwise it just clogs up the syringe. I found it best not to use remi's normal food and only really had success when I switched to a convalescence food that was very bland in flavour and very smooth.

    I used royal canin convalescence instant support sachets that are designed for feeding tubes. It's a powder that you mix up with warm water. It looks and smells like milk. However I used this before remi had diabetes and thus I have no idea how much sugar it has in it but would guess a fair bit.

    Here is the link to a place in the uk that sells it so not sure about the US but again not the best for a diabetic cat. There are other cat foods that are tinned that are designed for convalescence that may be smoother

    http://www.vetuk.co.uk/royal-canin-...n-convalescence-support-instant-sachets-p-254

    But I really feel it will become a lot easier if you can get hold of the ondansetron.

    There is a yahoo assisted feline support group. Maybe join that?
     
  91. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Thanks for the extra info, Sarah. :)

    I wonder if commercial cat milk might be another temporary food possibility (possibly lots of carbs but food is food and it would be available without an Rx - we could help you with the carb calculations. Pet stores might have powdered kitten milk formula.
     
  92. phlika29

    phlika29 Well-Known Member

    Joined:
    Sep 14, 2014
    @skinky44 I guess they didn't think she was nauseous and so didn't think it would be a problem to stimulate the appetite but in my experience nausea often accompanies inappetence
     
  93. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    What Sarah says above was borne out in my experience with Saoirse. She stopped needing the appy stimulant much sooner than she stopped needing the anti-nausea med (generic ondansetron).
     
  94. phlika29

    phlika29 Well-Known Member

    Joined:
    Sep 14, 2014
    Hi Aine :)That's okay. What I am not sure is at what point it is okay to feed a high carb food. I guess it is better for a cat to eat something because then at least you can administer some insulin to being down the numbers. What you want to avoid is infection, not enough calories and not enough insulin.

    @skinky44 Just to add Water can also really help with nausea. I would carefully syringe feed water. Aim for one side of the mouth to another. Go slowly, the same as when syringe feeding food, never aim straight down the throat.
     
  95. skinky44

    skinky44 Member

    Joined:
    Dec 19, 2014
    honestly, i'm amazed she has gotten this far. she is NOT hobbling or anything like that...she REALLY wants to eat now. but she won't. or drink. i've been stroking her for quite some time and she finally took a couple of licks of water. tomorrow a larger syringe is coming from amazon. I will fill that one with water if she makes it through the night. that's how it has been for awhile.

    I am beginning to think that she might have a fungal issue. someone sent me something about
    Cryptococcosis http://www.merckmanuals.com/petheal...ystems_of_cats/fungal_infections_in_cats.html "In cats, upper respiratory signs following infection of the nasal cavity are most common. The signs often include sneezing, bloody nasal discharge, polyp-like mass(es) in the nostril, and a firm swelling under the skin and over the bridge of the nose. Areas of small raised bumps and nodules may affect the skin; these may feel soft (liquid filled) or firm. These areas may ulcerate, leaving a raw surface. Neurologic signs associated with cryptococcosis of the central nervous system include depression, changes in temperament, seizures, circling, slight paralysis, and blindness. Eye abnormalities may also develop."

    I think this seems very accurate with her. it started with her sneezing. of course cat nasal cancer said the same thing too.

    i just don't know if/when i can get the necessary drugs to treat. and of course, maybe i'm wrong too.

    she developed a hot spot under her chin too, which seemed sudden. and i wonder if that is related to a fungal issue. i applied a little naftin scream to her nose. it seemed to help the lower portion of her nose...although the 'tumor' seems to have expanded upward toward the eye.

    she is developing some weird behavioral things too. my loveseat is RIGHT next to my bed (you know, manhattan studio, tight spaces). I'm on the loveseat now and she is on the bed, sitting on her hind legs, basically with her back to me. it's an odd thing for her to do.
     
  96. Marje and Gracie

    Marje and Gracie Well-Known Member

    Joined:
    May 30, 2010
    I don't think slippery elm will help with nausea. It's great for a lot of things and is a good nutritive but it's better for her to have food with calories.

    Ondansetron is a human drug and has to be obtained through a pharmacy with a script. Cerenia csn be obtained from the vet, usually, as it is a drug originally made for motion sickness in dogs. However, not all vets carry it.

    I also don't think either drug is widely used in veterinary practice......the cerenia more than the ondansetron so the inhumane vet might not be aware of them. My vet, who is excellent, was not aware ondansetron could be used in csts for nausea.

    I wonder if the mobile vet can subscribe an anti fungal? I'm assuming she is an indoor cat so how could she be exposed to a fungus? I know you live in NYC and there are a lot of pigeons...do you have your windows open where she could inhale spores from pigeon poo?
     
  97. Dyana

    Dyana Well-Known Member

    Joined:
    Dec 28, 2009
    Can you talk to one of your vets about what you found out about Cryptococcosis? Maybe they can call in a prescription to help with that.

     
  98. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    I was surprised to read that you don't think slippery elm will help: Tanya's site recommends it as a possible first line treatment for nausea. I thought that it might possibly help ease Skinky's digestive tract enough to help her get some actual food down (i.e. not use it as an alternative to 'food' food), especially as Skinky's mom might not be able to get an Rx for ondansetron or Cerenia till next week and the slippery elm might be an accessible treatment to tide Skinky over until an Rx med could be obtained.
     
  99. Marje and Gracie

    Marje and Gracie Well-Known Member

    Joined:
    May 30, 2010
    Tanya's recommends SEB for stomach acid and the accompanying symptoms (including nausea and vomiting). There's a difference. The SEB can be really good at coating the stomach to prevent stomach acid in a cat that is in early CKD. But that's why I said I "don't think" and not that it won't work. ECID....I've used it for nausea in my cats and it hasn't worked. The bigger issue, though, is getting it into her. Although it is tasteless, if Laura has to syringe it, some cats don't care for the consistency of it. I think you are right that if Laura cannot get ondansetron, then it's worth a try.

    My bigger concern is also that if she's having a difficult time getting her to eat anything at all, it might be better for her to get calories from food, if at all possible, and not fill her tiny stomach with SEB; I guess it's just a gamble either way.......
     
  100. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Thanks for the explanation, Marje, and also for sharing your experiences with slippery elm. Very much appreciated. :)
     
Thread Status:
Not open for further replies.

Share This Page