Spunky won't eat - ER now or vet in morning

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Spunky's Mama

Spunky's Mama

Member Since 2016
Spunky was diagnosed with diabetes just 5mths ago in November 2015. She recently went into remission (last insulin dose was the morning of March 31/16).
Yesterday I noticed that she seemed to have lower energy level than usual and was sleeping beside her water bowl.
Tonight (I couldn't get home for her 10pm feeding and was about 3hrs late), I went to feed her dinner. She did the usual purring when I gave it to her
I closed the door and went to attend to her siblings. When I returned, I noticed she had not eaten very much. I attempted to hand feed her. She took a couple of bites before giving up. I attempted other canned food and tuna and same thing - a couple of bites before giving up.
It's highly unlikely a dental issues as in December she had all but 3 teeth removed. She typically LOVES her food and I've never seen her turn it down. Feeding is usually a 4-5min process!
I smelled her breath and it did not smell sweet. I checked her sugar in case it was too low from dinner being late and it was at 3.4
I'm unsure if I should bring her to the ER now or if I'm just overly anxious and I can wait until her vet opens in the next 8hrs.
Has anyone ever encountered this?
 
Hi Spunky's Mama,

I hope Spunky's doing better by now, but if you feel she's in an emergency, I'd suggest editing the title of your post to include "911" so more members see it.

I'm afraid I'm a relatively inexperienced member here. I'm more familiar with the US human BG readers, but if I understand the conversion correctly, 3.4 is on the low end of normal? Is Spunky having any other symptoms? Does she have any other health issues? Were you able to get her to eat any more?

Two things come to my mind from experience with my own diabetic cat Jason who's been in remission for over 5 years now. The first is pancreatitis. It's presenting symptoms tend to be very nonspecific but inappetence and lethargy are common. Pancreatitis typically needs supportive care such as sub-q fluids, pain medication, anti-nausea medication, etc. Jason's typical flares tend to show as a poor appetite (he normally is very enthusiastic about his food) and a general malaise, where he's more lethargic and not as peppy as normal. Because of how nonspecific the symptoms were, he actually went undiagnosed for years until an extremely bad flare combined with an infection landed us at the ER vet last Christmas.

The other thing that I've experienced with Jason was related to him not eating often enough. He actually had a hypoglycemic seizure last July (when he's been off insulin for years). I'm still not entirely sure of the underlying cause (my vet suspects an insulinoma, but we didn't find anything on an ultrasound) but I've found that I have to feed him small meals every 6-8 hours to keep his system happy. If I'm too late with a meal, he'll vomit. When he had the seizure, he was only being fed twice a day, so about every 12 hours.

Hopefully some more experienced members will see your post soon.
 
Hi Spunky's Mama,
Hmmm.... If she usually loves her food but is suddenly not interested than that must be a worry for you.

There could be many causes; some simple and relatively 'harmless'; and some more serious.
As Sarah says above, pancreatitis is certainly a possibility with a diabetic cat.

Other thoughts... Is it possible she's ingested something that is making her feel unwell? Is there any sign of nausea or vomiting? Do you know if she's peeing/pooping normally? Any sign of injury, swelling, or obvious tenderness anywhere on her body?

Eliz
 
Spunky's Mama said:
It's highly unlikely a dental issues as in December she had all but 3 teeth removed.
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Another possibility would be a fragment of tooth left behind when the extractions were done. If she looks like she wants to eat but gives up, it's possible her mouth is sore. I'd check her mouth if she will co-operate and check with the vet who did the surgery to see if post op x-rays were taken to rule out this possibility.
 
I'd get her checked for pancreatitis. Both my own cat and a number of other cats I've seen here since joining seemed to develop nausea issues / pancreatic issues once insulin treatment was withdrawn upon reaching remission. If your vet has the facilities to do a SNAP fPL test you could get an answer on the spot as to whether the pancreas is inflamed. If you get a positive you might then want to consider getting further tests done including the Spec fPL which gives a quantitative measure of the severity of the pancreatic inflammation.

I second Sarah's recommendation to feed little and often.

Useful links:

Nausea symptoms and treatments

IDEXX pancreatitis treatment guidelines

If you are at the vets, ask for a B12 injection: it definitely helps pancreatitis but it may also help with poor appetite. Ondansetron is a very good med for nausea treatment. Cyproheptadine has a mild appetite stimulating action.

Spunky is soooooooo cute! :D Sending prayers and healing vibes for her to feel better very soon. :bighug:


Mogs

ETA:

Forgot to add hyperlinks when first posted. :oops: (Chronic fatigue and concentration issues really, really bad at the moment.) Links now working OK.

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Hey All - thank you so much for the feedback! She actually did get worse last night and began vomiting. Spoke with ER vet who encouraged me to keep checking her sugars and monitor her as she should be okay until morning.

3.4 is the low end of normal.

Vet did check mouth for healing process - I'm there so often that I honestly can't recall if x-rays were done on her or one of her siblings...

This morning she woke me up for breakfast and was in much better spirits. Devoured her entire breakfast in minutes and so far has not regurgitated it.
Her vet encouraged me to keep an eye on her for the day (I literally live there between 4 kitties :S and between school costs and them - I'm sinking into debt pretty fast :S ). Hopefully she continues to look good. Pancreatitis and the spot test I will definitely look into. Are B12 injections expensive or manageable?

Again thank you to all! What a helpful site and such a good idea! Trying to figure out this battle alone is not an easy endeavour and having no one facing the same challenges to chat with about it is even tougher!

She certainly is a cute :) Haha - Critter too - looks like my Boo who is now in kitty heaven

Christine
 
Oops! Just noticed that I didn't add the hyperlinks to my previous post. :oops: I've just added them now.

Spunky's Mama said:
Her vet encouraged me to keep an eye on her for the day (I literally live there between 4 kitties :S and between school costs and them - I'm sinking into debt pretty fast :S ). Hopefully she continues to look good. Pancreatitis and the spot test I will definitely look into. Are B12 injections expensive or manageable
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@Marje and Gracie - If you're around would you be able to give Christine some idea about the best and most cost effective way to give a course of B12 in the US?


Mogs
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Another fellow Canadian eh?! What part of our beautiful country do you reside in? I am in Toronto.

Spunky's Mama said:
Are B12 injections expensive or manageable?
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Sorry I don't have any idea what B12 injections at the vet's office would be (probably different depending on location and vet) and they are usually done intramuscularly in humans so if the same is true with cats, I don't think you'd want to be doing them yourself. I'm a retired R.N. and I tried AB intramuscular injections only to give up and deal with pills. Much harder to do than insulin shots and more uncomfortable for the cat.

Curious, and may be I missed it somewhere so forgive me if I have, but why do you want to give Spunky B12? There is a product called Zobaline you can order from the US which is used to help with diabetic neuropathy.
 
That's a great idea! Right now have been instructed to home monitor thanks to the small fortune I've spent in the last few months! Visa loves me lol!!!! She will have an appointment tomorrow if same issues present tonight. Breakfast went very well which is promising. Concern is that since coming off insulin, she really likes to hang out in the low sugar range which makes skipping meals and vomiting riskier.
Also in Toronto! :D
 
Spunky's Mama said:
Concern is that since coming off insulin, she really likes to hang out in the low sugar range which makes skipping meals and vomiting riskier.
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You don't have to worry about Spunky's BG going too low if she is not on insulin. Her own body will regulate her BG and ensure she stays safe. The more serious concern with a cat not eating and vomiting would be fatty liver but that would require more than skipping the odd meal or even a couple in a row but certainly cause for concern if it continues for more than a day or so.

I'm in the west end in Etobicoke.:D
 
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If it's cyanocobalamin for intestinal issues or pancreatitis, it is typically one subcutaneous injection a week for 6-8 weeks depending on the vet; some do longer, some shorter. I've never seen a month but really, at least six weeks is better. Then you switch to once monthly injections. However, the vet usually runs a GI panel beforehand and after the weekly shots to ensure there is a need for the shots although some will just start them without the panel. You should discuss with your vet.
 
MrWorfMen's Mom said:
You don't have to worry about Spunky's BG going too low if she is not on insulin. Her own body will regulate her BG and ensure she stays safe.
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In very rare cases, this actually can happen. My cat Jason (who's been off insulin since Nov 2010) had a seizure last July. When it happened, I never suspected his BG could be too low, since he wasn't on insulin. The only reason I realized it was a hypo episode was because I took him in for his bi-annual bloodwork that afternoon, and I got the results about 2 hours after his seizure. On the lab work his BG was 54 (ref range 72-174), and I immediately tested him on my home monitor and got a 35. My vet was really surprised by this and said that if it wasn't for the fact that I tested him at home and that I knew the blood sample from the previous day was handled correctly, he would have been sure the lab work value was due to mis-handling the sample. We still don't have a definitive diagnosis of what caused his hypo episode (my vet suspects an insulinoma, a tiny tumor on the pancreas, but nothing was visible on the ultrasound and no one was about to do an exploratory and start poking at the pancreas of a 17 year old cat). Anyway, it's extremely rare, but it is possible. It's certainly not something that I suspect is going on with Spunky, just wanted to mention that it can happen (albeit so rarely that it's practically unheard of).

I'm glad to hear that Spunky did well with her breakfast though! Like others have mentioned, I would check in to the possibility of pancreatitis for her.
 
Wulfwin said:
my vet suspects an insulinoma, a tiny tumor on the pancreas, but nothing was visible on the ultrasound and no one was about to do an exploratory and start poking at the pancreas of a 17 year old cat).
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Yes I agree completely.... it is possible but, in the big scheme of things, as you say, the likelihood is almost non-existent. The medical profession has a saying. "When you hear hoof beats, think horses not zebras." You rule out the horses first then go looking for the zebras. Admittedly, Spunky's Mom did not say how low Spunky's readings have been but she didn't say Spunky has experienced any hypo symptoms suggesting a zebra was present.

I hope Rain is doing better now and doesn't have any further hypo episodes. It's so hard when they get older and investigations alone start posing more risk than what ails them! I have an 18yr old and understand how frustrating that can be. :)
 
MrWorfMen's Mom said:
Yes I agree completely.... it is possible but, in the big scheme of things, as you say, the likelihood is almost non-existent. The medical profession has a saying. "When you hear hoof beats, think horses not zebras." You rule out the horses first then go looking for the zebras. Admittedly, Spunky's Mom did not say how low Spunky's readings have been but she didn't say Spunky has experienced any hypo symptoms suggesting a zebra was present.
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Oh, agreed! I wasn't trying to suggest that something like that has happening in Spunky's case, more so just mentioning that technically hypos can happen in cats that aren't on insulin.

MrWorfMen's Mom said:
I hope Rain is doing better now and doesn't have any further hypo episodes. It's so hard when they get older and investigations alone start posing more risk than what ails them! I have an 18yr old and understand how frustrating that can be. :)
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Rain is actually my newly diagnosed sugar cat, and we're still working on her. Jason is the one who had a hypo episode and he is thankfully doing well - increasing the frequency that he's fed seems to have done the trick. Oh, Jason just loves making my life interesting :) - he typically has one major health crisis a year (anything from diabetes, to trying to die from a rare side effect from methimazole when he was hyperthyroid, to a pancreatitis bout combined with an infection and a fever of 106 last Christmas). I'm hoping for no more major medical crisis from him til the end of the year, but I can't complain too much given that he was only expected to live a couple weeks when I first brought him home 5 and a half years ago (he was basically a hospice care foster). It is definitely tough when they get older though - I actually had my vet take all of his remaining pre-molars last Nov because putting him under anesthesia at his age makes me so nervous (he has terrible teeth, that was about the 5th or 6th dental in 5 years). It really does start becoming more of a balancing act and weighing the pros and cons at their age!
 
OMG! Jason has certainly put you through your paces! I hope he's had his fill of "medical adventures" for a while for both your sakes. My old guy is so crotchety, he has to be sedated for any vet visits so I am always weighing the pros and cons of whether a trip to the vet is needed. It's a tough situation and in my books my guy's happiness, as long as he isn't suffering, takes priority over twice yearly geriatric workups.:D
 
Etobicoke is nice! I'm west end near Lansdowne.
I agree that no longer being insulin dependent her sugars should sort themselves out. I get worried because of exactly how low they do get. I was checking every 3hrs last night just to err on the side of caution and by morning they were 2.9. Thankfully she got her appetite back and that continued to tonight. I haven't seen another vomit and she put up a lovely fight during her nail trimming session. Didn't think I'd be so happy about that! haha - means she feels better!

MrWorfMen's Mom said:
You don't have to worry about Spunky's BG going too low if she is not on insulin. Her own body will regulate her BG and ensure she stays safe. The more serious concern with a cat not eating and vomiting would be fatty liver but that would require more than skipping the odd meal or even a couple in a row but certainly cause for concern if it continues for more than a day or so.

I'm in the west end in Etobicoke.:D[/Q
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Yes - I will definitely be investigating that. I'm hoping to recover a bit financially before I jump into more testing. Spent probably close to $3000 in the last couple of months between all of them and just had to pay for another school semester.
Vet bills are brutal!

You seriously have been through hell! Despite crazy costs, I've been lucky as things have been for the most part under control. Seeing her walk again and go into remission when vets didn't think it was possible based on readings and timeline...a blessing!

Wulfwin said:
In very rare cases, this actually can happen. My cat Jason (who's been off insulin since Nov 2010) had a seizure last July. When it happened, I never suspected his BG could be too low, since he wasn't on insulin. The only reason I realized it was a hypo episode was because I took him in for his bi-annual bloodwork that afternoon, and I got the results about 2 hours after his seizure. On the lab work his BG was 54 (ref range 72-174), and I immediately tested him on my home monitor and got a 35. My vet was really surprised by this and said that if it wasn't for the fact that I tested him at home and that I knew the blood sample from the previous day was handled correctly, he would have been sure the lab work value was due to mis-handling the sample. We still don't have a definitive diagnosis of what caused his hypo episode (my vet suspects an insulinoma, a tiny tumor on the pancreas, but nothing was visible on the ultrasound and no one was about to do an exploratory and start poking at the pancreas of a 17 year old cat). Anyway, it's extremely rare, but it is possible. It's certainly not something that I suspect is going on with Spunky, just wanted to mention that it can happen (albeit so rarely that it's practically unheard of).

I'm glad to hear that Spunky did well with her breakfast though! Like others have mentioned, I would check in to the possibility of pancreatitis for her.
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Spunky's Mama said:
I get worried because of exactly how low they do get. I was checking every 3hrs last night just to err on the side of caution and by morning they were 2.9. Thankfully she got her appetite back and that continued to tonight. I haven't seen another vomit and she put up a lovely fight during her nail trimming session. Didn't think I'd be so happy about that!
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Actually that 2.9 is just at the bottom of what is considered "normal" numbers for a cat receiving insulin. For a non-diabetic cat the range of normal starts at about 2.2. Unless Spunky gets readings lower than that or starts exhibiting symptoms of hypo, I don't think you need to pursue any medical investigations for low BG causes.

So glad to hear she has her appetite back, no further vomiting and feisty catitude toward her mani/pedi.:cat: Funny how their lack of co-operation can be such a welcome behaviour!:woot:

Lansdowne isn't that far off! We're practically neighbours! :D
 
Well that is a relief! I didn't know that at all! The info I was left with was to basically panic if I saw numbers in the 2's! Good to know and thank you! Interesting how she now can sit in a much lower range than myself and her siblings! I totally checked all of us as a base for her :P
Glad that she is though!

We are practically neighbours!
Yeesh - If you ever need supplies let me know! - sucks when you run out (typically on a holiday) and struggle to find something open! If I have extras they are all yours. She has her own drawer now that is nicely stocked lol - I hardly have room for my own stuff!

What food do you feed your little one? I have Spunky on the D/M wet and dry. I know dry isn't good so I keep it at a minimum. Unfortunately can not afford a solo wet diet, especially since I need to be constantly prepared for vet bills recently :S. Regardless, I am not a huge fan of vet food as I don't find the ingredients that healthy. Have read too much conflicting information on diabetic appropriate food though that is not a vet brand which leaves me weary of what to choose!


MrWorfMen's Mom said:
Actually that 2.9 is just at the bottom of what is considered "normal" numbers for a cat receiving insulin. For a non-diabetic cat the range of normal starts at about 2.2. Unless Spunky gets readings lower than that or starts exhibiting symptoms of hypo, I don't think you need to pursue any medical investigations for low BG causes.

So glad to hear she has her appetite back, no further vomiting and feisty catitude toward her mani/pedi.:cat: Funny how their lack of co-operation can be such a welcome behaviour!:woot:

Lansdowne isn't that far off! We're practically neighbours! :D
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Spunky's Mama said:
What food do you feed your little one? I have Spunky on the D/M wet and dry. I know dry isn't good so I keep it at a minimum. Unfortunately can not afford a solo wet diet, especially since I need to be constantly prepared for vet bills recently :S. Regardless, I am not a huge fan of vet food as I don't find the ingredients that healthy. Have read too much conflicting information on diabetic appropriate food though that is not a vet brand which leaves me weary of what to choose!
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I have a rare cat who refuses to be transitioned to canned food. :banghead::banghead::banghead::banghead::banghead: I tried to get her onto the same mostly wet/little dry diet of my other 2 when I adopted her at 10 weeks old but she was having none of it. That standoff continues to this day so I am constantly on the prowl looking for low carb kibble options. Sadly, there is precious little out there and even less here than in the US.

The DM is expensive and no better than a lot of retail foods. My non-diabetics both eat Fancy Feast pates which ironically is an ideal food for a diabetic.:rolleyes: I have finally settled on Nature Valley Instinct Ultimate Protein which is 15% carbs for my kibble addicted sugar. Other lowish carb kibble here is Go Fit & Free at about 14% carbs & Instinct Raw Boost about 15%. One of our fellow Canadians in London put together this list of canned foods which you might find helpful and considerably easier on the pocketbook. Of course the choice of food always boils down to what they will eat. :cat:

To boot, my girl is also a rare IAA (Insulin Autoantibodies) cat so getting her numbers down has been a major struggle and the kibble has just added to the battle. She was diagnosed Feb 2015 and I saw hardly any movement in her numbers despite copious doses of insulin until just recently. Now she has turned me into a night owl due to her propensity to have low readings at her evening pre-shots. But better to get some lowish numbers than where she was and it sure is nice to finally start seeing some improvement. :D

Thanks for the offer of supplies but I'm so darn OCD when it comes to Menace, I won't ever be short. Like you, I am running out of space to put my stuff because of stocking up for her.o_O Have you thought about donating those supplies to a local cat rescue or shelter or DCIN? Another alternative would be to post them in the supply closet here. That reminds me, I need to contact DCIN again as I have insulin here that I am not going to use and want to donate.

Well time to go poke my furball again! :p
 
Critter Mom said:
Canadian food list:

https://docs.google.com/spreadsheet...0KlRA2ZVTk_tYNVRaoG_3Dfy64/edit#gid=964479244


Mogs
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Thank you!
Omg - when I started this journey I ran out of supplies once. Literally never happened again and I usually have extras now! Hahah - sometimes I have needles dropping out of my bag and I get the strangest looks from people!

Her insulin I'm hanging on to for a bit longer since she just entered remission and of course at any point could become insulin dependent again. If pattern keeps up I will definitely be posting here and making an offer to rescues! Her strips (depending on how long to expiration) I may end up donating regardless since she does not get tested daily any more (as of last week).

Oh man - that sounds rough with your IAA girl! Never even heard of that!

Tee hee - my boy Boo who has passed on was also a rare breed who would not eat wet. Most frustrating thing ever! He had no teeth and still went straight for the kibble!

Going to definitely check out this list of foods. Considering raw too if I can find a knowledgeable source whom can
Critter Mom said:
Canadian food list:

https://docs.google.com/spreadsheet...0KlRA2ZVTk_tYNVRaoG_3Dfy64/edit#gid=964479244


Mogs
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Click to expand...
 
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