Possible emergency post on Facebook group with "HI" BG and vomiting - possible DKA?

All - can anyone assist Missy on the Facebook group? Her cat, Pepper, was at the ER vet earlier today for mouth pain, and given Buprenorphine. Since they came home, Pepper has been vomiting (five times in one hour). Pepper is on Prozinc and due for a dose, but can't keep anything down - Missy isn't sure if she should shoot. Missy tested her twice and she is coming up as "HI". She is also going to do her best to try and check her ketones - is putting her in the bathroom to try and catch her urinating. ER vet is over an hour away. I'm not as familiar with dealing with HI or possible DKA - can anyone jump on the post? Link to thread here:
https://www.facebook.com/groups/felinediabetes/permalink/10155996096085202/

 

Dang Tara! I was out when you posted this. I'm stopping there now, though it looks like she's got some help.

 

She was posting regularly on FDMB not long ago but dropped out of sight. I wonder why she didn't post here?

 

I'm not sure. She said on FB that she stopped posting on the board altogether...I invited her to come back and visit our little forum and let her know that we'll be happy to help out at any time. Hopefully she'll join us again.

 

Update! Pepper has eaten half her serving of dinner, and kept it down for over 3o min now. She's had a dose of insulin and Missy got a ketone test in and Pepper is ketone free! She's going to monitor her tonight to be sure she's safe.

 

Thank you so much!! <3 I'll remove the 911.

 

Thanks for bringing this to our attention, Tara!

 

Thank you for all of your help. Thank you for inviting me back.

 

Hey Missy! So glad to see you back here! Please do keep us updated on how Pepper is tonight. I hope she's able to get some rest (and that you are too!).

We'll be glad to help you out WHENEVER you need anything.

 

<3 I will

 

Welcome back!

 

Thank you

 

Her BG is slowly coming down. She's at 564 now.

 

I can’t see your SS. What dose did you give her?

 

1.25. I was going to increase it tonight, until this happened. I'll go on my Google account and see if I can remember how to share her SS

 

Click on the “share” icon on your SS and then “anyone with link can view”. I think you have to paste the SS URL in there somewhere.

 

I'm glad to hear she's coming down! Has she thrown up anymore?

 

No.
I can't get her SS to post. I don't remember how to do it

 

Hello Missy, I saw the post on fb & was happy that you had a lot of people on board helping! I hope you have a good night with Pepper continueing to improve! I feel so bad when any of our kitties are sick. Big & get some rest if you can...

 

Thank you

 

Here we go again. She's throwing up everything (water). Won't eat and now she can't have her Cerenia because it hasn't been 24 hours. The Emergency vet is closed because it's Easter. Now what do I do? No insulin will be given at 730.

 

Post out on the main forum asking for advice needed urgently on dosing Cerenia.

 

I would only give very small amounts of food & water periodically. I had a cat that was not diabetic but had stomach issues. Small doses help calm the tummy. I know you can’t withhold food but the least amt that goes in, it will be easier on the stomach. You could also try 1/2 tab cerenia morning & other half at night. It might relax the tummy better this way. My vet advised me to do this when Baby vomited. I hope you get some answers soon...

 

I haven't fed her, she won't eat. It's bile

 

I apologize for the short reply earlier - just starting my morning routine with my three. Re nausea: she might need something that acts differently fornausea. One med that many use is ondansetron (human drug for nausea from chemo). Some people have used it along with Cerenia because it controls nausea by a different mechanism. There isn't much you can do today unfortunately.

Not ideal but this is what I'd do in your situation when no vet advice is available:

• leave her alone for a few hours - no food, no water, no testing, etc. Her tummy needs to settle.
• make up a slurry of pureed wet food and warm water to syringe into her in small amounts of a teaspoon or two every half hour to see if it will stay down
• if it stays down, continue until evening PS time
• get a ketone test if possible
• do PMPS and post here for advice re dosing
• if you aren't successful with that keep testing for ketones - this evening, tomorrow AM, etc. and call your vet first thing to discuss another nausea med or upping the dose frequency of Cerenia (they can also give her a Cerenia injection).

 

Another idea for later: give half the daily Cerenia dose in the AM and half in the PM if her vomiting calms down later.

 

More:
http://www.felinediabetes.com/FDMB/threads/cerenia-dose.148820/

 

@Kris & Teasel I finally was able to get ahold of another emergency clinic. I will be taking her in. Looks like the bupe dose yesterday could have caused the vomiting yesterday, but we are going to see if she has an underlying issue besides her mouth causing the issue. She could possibly be constipated. I found little piece of poop in my daughters room and another in the living room.

 

Good news about a vet visit. Constipation can definitely make them feel sick and bupe is a narcotic - renowned for causing constipation (and possibly vomiting). Please keep us posted.

 

Oh yeah constipation can definitly make her not want to eat and cause tummy upset. Do keep us posted. I'm glad you found an open clinic

 

We are at the vet as I speak. With palpation the vet said she has alot of hard stool (like a brick). She took her back and is doing an x-ray and enema.

 

Yes, and only 15 mins from home.

 

I'm so glad you found a place that close. An enema can work wonders even if it's a little messy ...

 

I'm praying this is the culprit. They are letting her hang out for 30 mins to see if she poops. If she doesn't, she might need sedated and manually extract the poop.

 

Well that's a pleasant job. Tell your kitty to lay those eggs herself. Lol

 

She went alot!!! She still has more to poop that can take up to 24 hrs to pass.They are giving her an injection of Cerenia and another RX of it to take home.

 

@Magic Johnson has experience with infant enemas and giving them to her kitty.

 

Oh good!!!! Maybe add some pumpkin or Miralax to her food to help as well.

 

@JanetNJ I will try. She's very picky and wants nothing to do with food at all right now.

 

She may start eating again soon now that she's cleaned out. . Best wishes for a hungry kitty

 

This has been a popular topic this weekend! I'm so glad she took care of business herself after the enema!

 

She still won't eat. Should I try tuna in water to get her to eat? She did not have insulin this morning and supposed to have insulin at 5.

 

I would try it.

 

She won't eat it. I feel like she's dying right in front of me. All she's doing is lying around. I understand that the last 2 days took alot out of her, but at least she was drinking earlier. Now nothing.

 

@Peppersmom72

Did you offer tuna juice?

She looks like a precious child! What was the status of the enema?

Did it all come out?

She’s not impacted right?

Do you have apple cider vinegar?

What are all her conditions? Age?

 

I don't know if it all came out. She went alot at the vet and the vet said she had more in there, and she should pass it within 24 hrs. She's 14. She's never acted like this after an enema. She looks distended to me, but I don't know if it's the way she's laying. I called the vet back and they said if I'm concerned to bring her back. I can't afford another $450 vet bill today. They gave her an injection of Cerenia. Could that do it? Yes, I have apple cider vinegar.

 

Does she seem like she has indigestion...?


think how you feel when you have indigestion and don't want to eat or drink anything...does it seem like that?

is she running a fever?

yea enemas cost a lot but I would not recommend one for her or even glycerin as she is not on her feet...she seems very uncomfortable...just looking at the pic

 

I don't know anything about Cerenia but in a very brief read...is should stop nausea...prevent vomiting...supposedly...again I have never used it.

Did you try tuna juice ? has she had it before? Maji took a while to fall in love with it. She was hesitant about it at first.

Tuna juice would do a world of good for her but not if she is throwing up.

 

@Magic Johnson she already had the enema at noon today. She hasn't ate or drank anything all day.

 

She loves tuna, but not today. She wants nothing to do with any kind of food/drink.

 

Her temp earlier was 99.1.

 

Ok temp normal

https://www.earthclinic.com/mobile/pets/acv_for_cats/poor-health/

ACV = Apple Cider Vinegar

Well just my two cents ( so you know what that’s worth). ACV is pretty safe - but needs dilution - I would read the link above several examples of ACV use for cats or other animals not feeling well and make a very weak solution and use a tiny oral syringe and see if you can get a little in her mouth to swallow - again weak solution, not a lot and be extremely careful of aspiration- if in doubt go to the vet. ORAL SYRINGE NO NEEDLE medicine type

We’re just talking a little diluted to get into her tummy and see if that can help with nausea

I and my husband take it straight when we have indigestion and we’re only talking a tablespoon max for us

I’m thinking a few drops and a little water - if you can do that safely orally and get a tiny bit in

Then let her rest 30 mins and see if it helps

Best I can do . She looks like an adorable child...again be careful not to have her aspirate anything !!!!

 

I wish I had some good advice on this, but I don't have much experience with it. Missy, has Pepper eaten ANYTHING today? Does she have a favorite food/treat? At this point, I'd give her anything she wanted if you can get her to eat.

 

@Peppersmom72
This below seemed like a good way to do it

“Use a syringe to administer clean, room temperature water to your kitty if she's not actively drinking from her water bowls. Allow her to lick or drink the water from the syringe, or administer the fluid into the pouch between her teeth and cheek.”

I would go this with A LITTLE ACV in the water

 

@Rachel she won't eat ANYTHING. She hasn't eaten all day. She drank a bit of water this morning and that was it.

 

You could try the ACV that Magic suggested above. I've never tried it, but I've heard others have tried it. Oh, do you happen to have Slippery Elm Bark? Some people here use SEB for nausea I think...

 

Sometimes they need appetite stimulant meds along with anti nausea meds. They can stop eating for one reason - eg. extreme discomfort from constipation along with nausea - and the not eating takes on a life of its own. I wonder if the vet clinic would give you some mirtazapine (appy stimulant) without you taking her back? I'd try syringing pureed watered down baby food, her wet food, anything meat/fish based tonight. Give small amounts frequently.

 

That’s a really good idea!!! Most of the time if you’ve spent a fortune they do it as a courtesy

 

I agree, ask for an appetite stimulant. In the meantime I would syringe in some watery pate food directly into her mouth.

 

We're back at the vet. They are giving her more fluids, syringe feeding her some calorie booster stuff and a shot of antibiotic for her mouth. She's also going to use some novacaine and pull her dangling k-9 that is very painful. That may be why she's not eating.

 

She's still NEGATIVE for ketones......and she Sh#+ on the vet. Lol

 

Good luck! Hurray for negative ketones - and evidence that the enema is still working.

 

Haha well that should make you feel better about the bill. Lol. I'm glad they are taking care of the tooth!! I didn't realize it was dangling.... She should feel so much better after!!!

 

Lol...occupational hazards for the poor vet!

A dangling tooth does sound awfully painful. Hopefully getting it removed will help. Keep us posted on how she's doing.

 

Lolol

 

Change of plans, she's not removing the tooth. Damnit! She just gave the gum a shot of novacaine

 

Awe man why not? Just get it over with.... Otherwise you'll just be back in a few days

 

???

 

I thought this was a typo ...then I read-read... that is awesome LOL!!! Gave it right back to em....

 

What?? She ought to just yank the tooth...dangling tooth could definitely cause inappetence because it's gotta hurt!

 

I started crying and she pulled it out.

 

Not sure what she was thinking wanting to leave a dangling tooth in Pepper's mouth ...

 

So it's been taken care of them? Thank goodness! Made no sense to leave it in and have to numbers it again and put her through another trip to the vet.

 

What a stressful day for you. ((Hugs)))

 

Excellent!!!

 

I brought all of her meds with me, so she gave her her bupe, her appetite stimulant, an injection of B12 for her stiffness and an antibiotic injection for her mouth, pulled her tooth and didn't charge me for any of it. I walked out of there spending under $200. I was concerned I would have another $460 bill from earlier. So in two days I've spent $800 for my baby.

 

She's hovering her water dish right now. She's stoned and guarding it.

 

I love your pics of her! You did fantastic!

Just a checkup for Maji - a checkup ...ends up close to $200 - you did super on this vet visit and it sounds like everything’s gonna be ok

 

@Magic Johnson should I be concerned about letting her drink too much?

 

She might be dehydrated from the vomiting. I’d let her drink as much as she wants. I hope she starts to feel better soon and gets back to eating normally.

 

@Kris & Teasel it won't make her vomit to drink alot of water?

 

Vet gave her appetite stimulant with her pain meds, she's eaten a couple bites since we've been home and loving her water bowl right now.

 

I’m not sure at this point. You could try offering some then take it away, wait a bit and offer again. This way you can watch to see if it stays down.

 

Oh thank goodness she ate a little

 

No - let her drink as much as she likes

 

Hope she's feeling better today

 

How's she feeling today? The bupe probably made her a bit stoned...it can do that to kitties. I hope that the combo of things she got helps her feel better and eat!

 

Thank you everyone! Pepper is doing a little better today. She is still a little weak. She has eaten a serving of her food this morning, very watered down. She is fighting me on pain meds. She doesn't want it. So, I stopped trying. She even let me brush her. I do have one question though. Does anyone know how to read an x-ray? I'm curious as to if that's all poop I see on the side view taken before enema (vet said she was extremely constipated)

 

Wow that’s a lot of poop in there looks like Majis X-ray from 2 years ago!

I attached a diagram

 

@Magic Johnson is that poop (the big round thing under her kidneys?

 

You mean where it’s dark and then lighter stuff in there? Yep I believe so - I’m no expert tho

She really does look like Maji did a lot of poop - is this BEFORE the enema?

 

@Magic Johnson yes before the enema. I'm hoping the higher stuff is moving down. She started eating better this morning and came out to the living room to sunbathe. She even meowed at me for some food, but took a couple bites and walked away.

 

She is sounding quite a bit better and you know her mouth may hurt a bit from the extraction! Good job on getting the tooth extraction!

 

This might help:
http://www.perthcathospital.com.au/bunged-constipation-cats/

 

She's got more pep in her step today. Shes's watching the birdies outside, and eating pretty good too. She won't leave my side, but I'm not complaining. I took a vacation day today to be with her and make sure she was ok. I think her and I will both have a little separation anxiety when I go back to work tomorrow.

 

She looks perky in your photo - pretty kitty!

 

@Kris & Teasel thank you so much.

 

She must be feeling so much better! She looks good in the picture!