Took to vet today. Given appetite inducer. Still barely eating. What now??

Hi guys, posted in here last night and I got a some great responses and advice!

Nate had been eating pretty well over the past 9 days since being diagnosed. He was being picky, but I could get him to eat a good amount in the morning, but he didn't want much in the evening. Yesterday he ate a little less than usual in the morning, about 2 ounces of wet food. Last night he wouldn't eat any wet food at all, but did eat about 15 individual treats, Whiskis Temptations. I was reluctant to give him his shot, but I did and he seems totally fine. I just tried to feed him this morning and he doesn't want anything. No wet food at all. I tried lunch meat and tuna, no go. He just ate about 4 Temptations. I feel like that's not enough to give him the shot.

I took him back to the vet this morning and had him tested for Ketones. They said he didn't have Ketones, so good news there. He is showing no symptoms of Pancreatitis, so they didn't feel the need to do blood work again since he just had blood work 9 days ago. They gave him an appetite inducer, anti-nausea medicine and injected him with fluids. They sent me home with a bottle of appetite inducers that I am to give him every 2 days.

I took him home and he STILL barely ate anything. I tried to feed him multiple cans of wet food, tuna and treats, to no avail. Finally got him to eat a few decent bites of my turkey lunch meat and a few bites of Friskies wet food.

I did give him the shot, even though I really wish he had eaten more.

I guess my question is: What now??

I have tried every kind of wet food recommended on this forum. I sprinkled Paremesan on wet food. Now I've given him another appetite inducer and nothing is working.

He doesn't have Ketones or Pancreatitis, although the vet said he is "borderline DKA" which scares the hell out of me. They said it was safe to bring him home and that if he really had DKA, they would insist on keeping him.

I am at my wit's end with all of this! I am stressed beyond words. I worry about this constantly. I am just feeling very hopeless right now. Of course, I will never give up on Nate!

Do any of you wonderful people have any advice for me? Anything else I should test for? Any magical food that Nate will love? Anything I should be asking my vet? Anything I can do to help this situation at all?

PS: I am buying a home tester after work tonight.

Thank you in advance!

 

Would you be willing to try some human baby food meat? When Idjit is sick it's our go to. I just get the Beechnut brand (no additives) and mix it with warm water for soup. You can offer small amounts fairly frequently. I use primarily the chicken and turkey, veal, beef but not the ham. Have you tried mixing his wet food with warm water for soup? sometimes the consistency helps.
You could also try just boiling some chicken breast (don't overcook), and offer bits with some of the broth.
Or if you are willing, you could try the Liver Shake for sick cats. I haven't personally tried it but it's in the FAQs forum so someone has!
http://www.felinediabetes.com/FDMB/threads/the-liver-shake-for-sick-cats.30432/
I hope others will have more suggestions.

 

It would be very helpful if you would create a signature so that Nate's information is available with each of your posts:
(light grey text under a post).
Here's how:
click on your name in the upper right corner of this page
click on "signature" in the menu that drops down
type the following in the box that opens: kitty's name/age/date of diabetes diagnosis/insulin you're using and dosage amount /glucose meter you're using/what (s)he eats/any other meds or health issues (s)he has. You can add your name, and a geographic location (sometimes the time zone matters)
2. Another thing that will help us help you when you've started BG testing at home is to set up a spreadsheet like the one we use here. We can all see it and look at it before offering advice:
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/

 

Maybe he would like some bone broth? It can be given alone or mixed with wet food. https://healthypets.mercola.com/sites/healthypets/archive/2013/12/02/pet-bone-broth.aspx

 

Hello! Sorry we didn't get back to you on the other thread. I'm usually only in for a bit in the morning and then again at night when I get home from work. I can sometimes pop in during the day, but it's never a sure thing. Others are on here when they can be as well, but it's kind of hit and miss during the day.

Did the vet explain what they mean by borderline DKA? Did they say if he had any ketones at all? That's weird...I'm not sure what it means. Did you manage to get any ketone test strips from a pharmacy? I would get some if you didn't and try to test as soon as he goes to the litter box. You basically stick the strip in his pee stream and read it at the time on the bottle...usually 15 seconds. Just be sure to read it exactly at that time as it does get darker over time. If you need tips on getting some pee to test, we can help, though I always found Gypsy just let me stick it in her pee.

As for the food, the baby food Lou mentioned above is a great choice. Just make sure to get the all meat kind. Some cats will eat that when they won't eat anything else. Try warming it up too to make it stinky so Nate smells it. What does Nate do when he sees the food? Does he just walk away or turn his head or take a bit or two and then walk away? Does he lick his lips or anything?

I'd call the vet and ask them what they mean by borderline DKA if they didn't explain. What appetite inducer did they give you? Did they have ANY explanation of why he might not be eating? Did they give any instructions for if he won't eat even with this on board?

I'm sure this is really scary for you, and you're doing a GREAT job staying calm and handling things. Sorry for all the questions. We're just trying to get to the bottom of what is going on as best we can, but I know I can sometimes sound not that sympathetic when I'm firing off 10 zillion questions at you.

 

No, I haven't tried any of those things. I will pick all of that up tonight. Thank you!

 

I definitely will do that tonight!

 

I'll add that to the list. Thank you!

 

Like Rachael I am wondering if he is showing signs of nausea. Giving an appetite stimulant when a cat is nauseated is not going to work. Do you know what they gave Nate at the vet's office? Sounds like they may have given him a shot of Cerenia. I'm surprised they didn't send a script for more anti-nausea meds along with the appetite stimulant. With dosing every 2 days, seems the appetite stimulant may be mirtazapine. You may need to call the vet for a script for Ondansetron and/or more Cerenia. The two meds work on different nausea receptors. If the mirtazapine doesn't work, you can ask the vet for cyproheptadine, another appetite stimulant.

While they told you Nate does not have ketones, saying he is borderline DKA implies he does have them to some degree. I'd definitely get some ketostix to check for ketones yourself.

 

No worries! You have been nothing short of amazing. I am so grateful!

Honestly, I have no idea what she meant by the borderline comment, as I only have a vague understanding of what DKA is in the first place. I will definitely call them and ask. Are there any other specific questions I should ask about that?

I haven't had a chance to buy the home testing stuff yet, as I had to go to work right after the vet, but I am after work.

When he eats, or rather doesn't eat, he sniffs the food, picks his head up, turns and walks away. Sometimes he will lick the juice or sauce, and when that's gone he will take a bite or 2 and walk away. I have noticed when he chews, he turns his head to the side and does a couple big chomps. I know the vet has been checking his teeth on our visits. He may have always eaten like that. I never paid this close attention before. He does almost always lick his lips afterward.

The only explanation I was give for why he might not be eating is "his levels are off" and that this is very common for a newly diagnosed cat. All they said if this doesn't work, to being him back in and they will keep him for a day and syringe feed him/ give him his insulin.

I will have lots more questions for you tonight or tomorrow when I have the testing stuff.

Thank you Rachel!

 

Hmmm....that's odd. Yeah I'd call and ask them what borderline DKA is and ask if he had any ketones. If they say yes, ask what the level was.

I'll probably be offline later tonight when you post (I'm an early to bed person because I get up so early) but I'll check on you in the morning. I'm usually on around 4:30 or 5 CT in the mornings during the week. And others may be online later too to help out!

 

Just called the vet. She said there are no Ketones at all in the urine or blood. Said he just has a high glucose level.

She said if he doesn't start eating in 24 hours to bring him in and they will basically force feed him, give him insulin and keep him overnight, which I REALLY don't want to do. Can I force feed him at home?

 

They gave him:
Cerenia injection - under 20 lbs
Fluids - Subque
Mirtazapine 15 Mg
Ultrasound Guided Cystocentesis
Urine sediment or strip only

I just called and asked about an anti-nausea script and they said yes and I could come pick it up any time.

They said he absolutely has no Ketones in his blood or urine, just high glucose.

Thank you!

 

Glad to hear there were no ketones. Now to get Nate back to eating! Surprised they didn't send home some Cerenia in the first place!

 

I know! Starting to not like this vet. Thinking about taking Nate elsewhere next time.

I meant to ask you: What are some signs of Nausea?

 

Signs of nausea could include drooling, lip licking although they haven't eaten for awhile, lethargic, restlessness. Often kitty might approach food dish, sniff it and walk away possibly licking their lips despite not eating.
Just curious.....did the vet palpate Nate's tummy during the exam for any tenderness? Pancreatitis can cause kitty to go off their food and it tends to be common in diabetic cats.

 

Hmm, I haven't seen Nate display any of those symptoms really.
She did examine his stomach and said he appeared fine physically. When his blood work was done 9 days ago I was told he did not have Pancreatitis. When I asked about it again today she said he is showing no symptoms of Pancreatitis.

Ugh, just want answers!

 

That would definitely count as signs of nausea.

And as an own of a cat with chronic pancreatitis, it sounds an awful lot like that to me. There is absolutely no way to know for sure just by a physical exam because cats hide their pain - especially when they are stressed like they are at the vet. And even the blood tests aren't particularly accurate. There are two: the snap-fpl, and the spec-fpl. The snap is cheaper, and less accurate. The spec is more accurate, but more expensive. The hard part is that while a positive result means they have pancreatitis, a negative result may not mean they don't have it since the tests just aren't all that good.

It does sound like your vet did a few things right: giving the fluids, the appetite stimulant, and the cerenia. My hunch is that either it is ketones (I really hope that isn't it!), or there is also pain involved and that is contributing to the aversion to eating.

If you can get some CBD oil that doesn't have any additives - just CBD and oil (usually olive oil or coconut oil), that would help with both the pain (if it is pancreatits) and the nausea. CBD is legal in all 50 states, so it's just a matter of finding some that doesn't have added sugar - and especially no added artificial sweeteners (they can be toxic).

 

Yes I use CBD for my cats for a different issue, and I do think it helps.

I'd make sure to get your own ketone test using the urine test strips as soon as you can to be sure. I'm glad the vet gave you some cerenia you can give at home. I think that'll help with any nausea.

 

I am picking up some CBD oil! Thank you.

 

Think it's safe to use Cerenia and CBD oil at the same time?

 

Nate still hasn't eaten much as of Thursday AM. The vet wants me to bring him in by tomorrow to force feed him and give him insulin. Is there an at home alternative to force feed him? Would any of you recommend it?

 

Can you syringe feed?

 

I haven't tried that yet. I imagine a huge fight from Nate. Is it worth it to save him the stress of the vet?

 

I think that depends on your cat. I have had a couple of occasions when I had to syringe feed. I would be concerned about why he still won't eat. Is the vet planning to do any more to try and figure that out? Are you giving him Cerenia? CBD oil, too? Were you able to try any of the suggestions like baby food?

 

Yes, my girlfriend just picked up the Cerenia and gave it to him at noon. Not sure if Nate ate afterwards since she had to get back to work. I am going to pick up the CBD after work. I tried the baby food and he didn't eat it. Licked it for about 20 seconds and walked away. Not sure if it was the exact right kind though. I didn't see any meat chunks in it, even though it said Turkey/chicken/beef.

All the vet told me is they would feed him intravenously, give him insulin and test his levels throughout the day. She didn't mention other tests. As I mentioned I have really started to not like this vet. As soon as Nate is feeling better I am taking him elsewhere. What other tests should I ask for?

 

You can syringe feed at home, but I've never done it so I don't know how hard it would be. As for other tests, they really need to help figure out why Nate isn't eating. Saying it's just because he's newly diagnosed and not regulated doesn't make any sense to me. We have tons of cats here who have been newly diagnosed and not regulated and very rarely will they not eat. In fact, most cats eat MORE at first due to the poor regulation. I'm not sure what else to ask them to test for, but we really need to know why he won't eat and how to treat that.

 

Here’s some info on syringe feeding
http://www.felinediabetes.com/FDMB/threads/syringe-assisted-feeding-video-and-tips.144367/
Ive had to do it many times. Hills AD food is a bit high in carbs, but easy to syringe and full of nutrition.

ETA the AD is 12 carbs. You can also use all meat baby food, but try to get some cat food in him for the nutrients.

 

I am going to be very demanding next time. I am going to tell them we need to do any test there is to figure out why. They are making me so mad. So far they took an X-ray and said there is no blockage anywhere and no tumors. Then I demanded they do blood work and they said he's diabetic, but does not have Pancreatitis. Then I had to demand they test for Ketones and they said he has none. Of course I am not a vet, but I definitely feel like they should be running other tests and quit telling me this is common!! Ahh!!!

I would take him to another vet, but at this point they have all his charts. Not sure going to a new vet is the best move, even though I want to.

 

Do you have a copy of his bloodwork? If so, post it and we’ll get someone to look at it. Maybe she’ll see something to help.

 

And if you don't, call and ask them to give it to you. It's yours after all and you should be able to have a copy.

 

I don't have it, but I will for sure be asking for it and posting it here tomorrow!

 

Unfortunately low grade pancreatitis sometimes does not show up in bloodwork and can suggest there is no problem when in fact there is. Since pancreatitis is a common issue with our diabetics, it might be worth asking for some buprenorphine for pain (pancreatitis can be painful but not always noticeable on abdominal palpation), anti-nausea meds (cerenia and/or ondansetron ....they deal with different nausea receptors) and an appetite stimulant (mirtazapine or cyproheptadine).

 

Deep breaths. This is all scary and frustrating, but please know that while pancreatitis is kind of awful, it is treatable and it resolves in its own time. Quite often it's diagnosed just by virtue of there being nothing else wrong. So as long as ketones aren't the issue, it's quite likely it's panc. So for now, let's just pretend it is, and talk about treatments. You're already on the right track with everything except pain meds. You can start the CBD now, and then talk with the vet about getting some bupe. Although to be honest, I rarely use the bupe anymore as Sam responds better to the CBD. I do like having it on hand though as the bupe is stronger so it's nice to have when he gets hit hard.

The CBD should help with the pain, and yes you can give it with the cerenia. In general I avoid giving CBD and buprenorphine at the same time, but CBD and just about anything else is fine.

As far as the feeding, if he won't eat your two options are syringe feeding or getting a feeding tube. Syringe feeding can be messy because cats aren't super cooperative, and you need to do it a lot, little bits at a time. A feeding tube requires a vet visit, but is a little easier once it's in. Then it can be removed once he starts eating again. I haven't needed to go the feeding tube route myself yet, but there are folks around here who can tell you more if that ends up being the best option.

As you know, cats really can't go without eating the way other animals can, so I would say give the syringe feeding a try tonight, and if it doesn't work, head to the vet. Nate needs to get some calories in him soon.

Meanwhile, hugs to you and your GF. Around here we often say we're sending "vines". It's like our version of prayers/positive energy/etc. So know that we are all sending healing vines to Nate and hope that he'll start eating for you soon!

 

I know they gave fluids at the vet, but you may want to ask them about giving him subQ’s at home.

 

Try FortiFlora on the food. It's a probiotic and flavor enhancer. It really sounds like pancratitis to me. If it is, the treatment is usually sub q's for hydration, cerenia for nausea, and bupe for pain.

 

Tiki Cat Velvet Mousse is a good food to syringe feed.

 

Thank you so much! You just made me tear up! ☺

 

Hello all you wonderful animal lovers. We went to the pet store last night and bought Nate CBD oil. It is Pet.releaf Hemp Oil 330. Now after buying it and getting home I read Hemp oil isn't as good for nausea as pure CBD oil, although it says it "includes naturally occurring CBD". Anyway, having nothing to lose, I gave it to him along with his vet prescribed nausea meds.

To my delight, it worked! He ate about 1.5-2 ounces of wet food. I was so happy I could have cried. I gave him his insulin and went to bed hopeful.

Well, this morning I gave him his appetite inducer (that I am supposed to give him every 2 days), his anti-nausea and his CBD oil. I waited half an hour and tried feeding him. He is not having it. Refused to eat everything I put in front of him. 3 different brands of wet food, baby food, turkey lunch meat. He licked them a bit, had maybe a few tiny tiny bites, but that's it.

I just called my vet and said I do not believe it's just his diabetes causing his refusal. I want to do any test possible to figure out why he isn't eating. They told me he needs hospitalization, meaning they need to keep him, force feed him, give him insulin, check his levels, etc. I am taking him in, in an hour. They said we will come up with a game plan. I think they will want to keep him overnight.

I have been dreading this for so long. I feel like I am abandoning Buddy Boy. He is going to be petrified at the vet, but I know this has to be done. We have to figure this out. Can any of you talk me off the ledge? Convince me my poor buddy won't be crying in fear the entire time, missing me?

Please wish Nate and I luck! Thank you so much.

 

I think we all know how you feel! I absolutely hate leaving my babies at the vet, but that is the best place for Nate right now. Maybe bring along one of your T-shirt’s so he will have your scent to help calm him. Please keep us posted and be sure to get any test results so you can post them here.

 

That's a good idea! I will definitely bring a t-shirt with me next time. I will be asking for copies of all test results and procedures done!

 

I know I would be a wreck if I had to leave one of my fur babies overnight at the vet, and yet sometimes it's needed. Nate needs to get some food in him, and if assist feeding him at home won't work, then it's off to the vet. They won't be able to get the diabetes regulated at the vet, as that takes many weeks (and sometimes months), but if they can get him back on food, that is the most important thing right now. Then you can bring him home and keep working on the insulin dosing. I think Sharon's suggestion about bringing something familiar to keep with him will be good. And we'll keep those vines heading his way. Along with some vines of comfort for you, too!

 

I've had to leave one of my babies at the vet all night before and I was miserable yet I knew she needed it. It was the right choice because it helped me determine what was wrong with her and honestly, she was fine within a few hours of getting home. She slept A LOT for the first day but right now she's sitting above me on the back of the couch, happy and healthy, and best of all I have a game plan to put into place whenever she gets sick.

It'll be scary and stressful for you, but if they can figure out what's going on and get him eating again, that's what is most important. That will really help you both because when he comes home you won't have to deal with refusal to eat on top of diabetes. Please do keep us updated and let us know how things are going! And sending tons and tons of vines to you!!!!