Diabetic Cats + Gassing, Asthma & Constipation?

Hi friends!
It's been quite a while. (here's our last post: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=82933) Sushi and I have just been cruising along...he's not quite regulated, but I have been more aggressive with making needed dose adjustments, and he usually ends up in the "happy" range of 50-200. His spreadsheet is not up to date, so forgive me.

However, it seems our happy cruise has come to an end. For a little over a week, his breathing has been quite labored, he's constipated, and not eating as much as he should be. His blood sugar is quite high -- consistently in the 300-400+.

He got into some of my daffodils Thursday before last, but seemed to throw it all up almost immediately, and after keeping a close eye on him for 36+ hours, I decided against bringing him to the vet.
A major factor in that decision is Sushi gets extremely stressed, anxious and aggressive at the vet. To the point of it being counterproductive. The vet staff aren't able to do what they need to to take care of him, examine him or treat him.

After several days of the labored breathing, constipation and decreased eating, I brought him to the vet Friday. Of course she wasn't able to do much of an examination because of his usual vet behavior, but she mentioned he might have asthma. She said the tricky thing with that is asthma is usually treated with steroids, but steroids tend to increase blood sugar.
She also wanted to gas him to calm him down enough to do a thorough examination and x-rays. I was wary of that idea (isn't gassing bad for diabetic cats?), so she sent me home with some oral steroids and antibiotics.
Of course, Sushi's blood sugar remains high. I haven't seen any improvement, in fact today he's having to open his mouth to breathe.
He FINALLY pooped a bit just now, but his stools are incredibly hard and he's not pooping enough (quantity or frequency).

I guess my next step is to bring him back to get gassed and x-rayed. But I'm still wary of having him gases.

Also, the more I think about it, it concerns me that the vet didn't find his high blood sugar, decreased eating and constipation much of a worry. These are critical factors for a cat with diabetes.
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Does anyone have any suggestions?

What about for his constipation?
I've tried Vaseline and forta flora, but they don't seem to be helping.
The vet suggested some sort of gel that contained sugar for the constipation, so I didn't go for it.

Is it okay for the vet to gas him?

Any suggestions for making him more calm at the vet?
I'm using Feliaway.

Do any of you out there have diabetic cats with asthma?
How are you treating it?
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Here's a breakdown since Sushi ate the daffodils:
Shot time is ~6:30 am/pm | Nadir is ~12:30pm
Thursday 3/6:
12:30pm 198
Afternoon/~5:30pm? Ate 2 flowers (small) & a bit of a leaf of a daffodil
6-8pm: threw up 5-6 times yellow (daffodil was yellow) mucus-ey & bits of plant
8pm: drank ~1/4c of water 181
8:30pm: fed 3oz of 9 Lives canned & 2 units of Latnus
11:30pm: Fed another 3oz of 9 Lives canned
Middle of the Night: threw up 1-2 oz of food / did eat all food

Friday 3/7:
6:12am 386
7:45am: Fed 5oz of 9 Lives canned & 2 units of Lantus -- 394
8:19pm 272 fed 3oz of 9 Lives canned & 2 units of Latnus

Saturday 3/8:
7am popped in litter box then a BUNCH all over my shirt--normal & smeary
8:09am 321 Fed 5oz of 9 Lives canned & 2 units of Lantus
8:24pm 366 Fed 5oz of 9 Lives canned & 2 units of Lantus

Sun 3/9:
afternoon started breathing really heavy--through mouth at times
Didn't poop all day
8:04am 355 Fed 5oz of 9 Lives canned & 2 units of Lantus
2:42pm 281
8:10pm 319 Fed 5oz of 9 Lives canned & 2 units of Lantus

Mon 3/10:
gave some Vaseline about an hour before feeding
6:48am 210-- “skipped” (just gave 1u) at 6:30am to get caught up with schedule & time change + 5 oz of 9 Lives canned
8am – pooped about a days’ worth
12pm 90
5:30pm 354 Fed 5oz of 9 Lives canned & 2 units of Lantus
11:20pm 323

Tue 3/11:
6:09am 322 Fed 5oz of 9 Lives canned & 2 units of Lantus
5:45pm gave some Vaseline
7:22pm 319 Fed 5oz of 9 Lives canned & 2 units of Lantus

Wed 3/12:
put 1/3 tab of forta floura in food @ am & pm
6:48am 437 Fed 5oz of 9 Lives canned & 2 units of Lantus
12pm 343 Pooped normal amount
6:40pm 306 Fed 5oz of 9 Lives canned & 2 units of Lantus
10:45pm 305

Thurs 3/13:
put 1/3 tab of forta floura in food am & pm
6:49am 326 Fed 5oz of 9 Lives canned & 2 units of Lantus
5:38pm 228
7:30pm Fed 5oz of 9 Lives canned & 2 units of Lantus

Fri 3/14:
put 1/3 tab of forta floura in food am
6:53am 314 Fed 3oz of 9 Lives canned & 2 units of Lantus
7:30 am pooped a bit
12:41pm 351
5:10pm--328
7:12pm increase to 2.25u - Fed 3oz of 9 Lives canned - 340
Gave steroid in evening

Sat 3/15
7:02am - 364 Fed 3oz of 9 Lives canned
put antibiotic in am food
7:11pm- 200 Fed 3oz of 9 Lives canned
8:30pn--gave steroid

Sun 3/16
7:03am - 443 Fed 3oz of 9 Lives canned
10am 285
10:30am gave antibiotic
6:55Pm put forta flora in food - 305 Fed 3oz of 9 Lives canned
8:30pm--gave steroid

Mon 3/17
6:45am 428--increase to 2.5+u
Put 1/3 capsule of forta flora in food
Gave steroid & antibiotic Fed 3oz of 9 Lives canned
11am pooped a little bit

Ashley --

They don't need to "gas" him for anesthesia. They can use a sedative by injection. Sushi needs to go to the vet regarding the constipation.

As for the asthma, there are any number of FD kitties with asthma. You can work the insulin dose around steriods. After an initial period, it's likely that you will use steroids by inhalation (i.e., an aeroKat) and this has less of an effect on GB.

Hi Sienne!
Thanks for your reply. I'm guessing the vet suggested gassing because Sushi was/is too hostile to give an injection. Any suggestions there? What do I say if the vet insists on gassing?

I did bring Sushi to the vet for constipation; she recommended a gel-based medicine that contained sugar. I remembered seeing posts about this in the past, and decided not to take her up on this medication. Is there anything else I can try?

Thanks again

Could you pill Sushi with a sedative you get from your vet? I had to sedate my feral Misty to bring her to the vet.

Was it lactulose she suggested? You can use Miralax instead-- 1/8 tsp mixed in to wet food twice a day.

Bach's Rescue Remedy is great for anxiety=it's all natural flower essences. I use it for myself and my cats.

I agree, he needs a vet visit. I'm surprised she didn't give him an enema. He may be dehydrated and not enough water to pass the stool in his system.

That's an idea, Larry! I hadn't thought of that. I'll suggest it and see what the vet thinks.
Thanks so much! : )

Thanks Laura!
Where can you buy the Bach's Rescue Remedy?

The vet probably didn't give him an enema because he would barely let her touch him with a stethoscope! ;-) I'm sure whether he's dehydrated or not. I'm adding water to his food, and he's urinating okay. But he's spending time in the tub, soooo... I just gave him some water. We'll see!

Thanks again : )

open mouth breathing is an emergency!

There are various possible causes, and it could be asthma, or it could be heart related. I would get him in ASAP. They may be able to get an idea of whether there is fluid in his chest by listening to his breathing, but an x-ray will be much more reliable. He might need oxygen in the meantime. I would get a diagnosis before worrying about steroids. Breathing trumps diabetes.

If he does have heart disease, then gassing is worrisome but getting the x-ray done is pretty important. I don't have a good answer to that, other than to ask the vet about risks vs. benefits and weigh what they say very carefully. They might be able to sedate him only partially and do the x-ray quickly. I know it's really tough when you have a fractious cat, and if he can't breathe he is likely to be even more panicky than usual.

Ashley:

I second the idea of getting a sedative pill from the vet and giving it to Sushi at home, then taking him in once he's calmer. It might make all the difference. Some health food stores carry Rescue Remedy, or you can get it through Amazon.com. Good luck!

Any update?

Can you find a vet who does house calls?

Also, once a vet determines he is OK, Feline constipation is a good site which explains how the feline GI tract worsk and what interventions are possible when it doesn't.

Hey, thanks for the responses everyone!

Just hopping on to give an update. I finally talked with a vet tech, who was acting as a go-between between me and the vet. They said they could give me some sedation meds to give him at home, but they would still have to gas him when he got there. I asked if they would be able to sedate him via injection instead of gas, and the tech couldn’t answer that for me.

He stopped open mouth breathing around mid-morning, and I had to leave at 1pm to come to work. The vet did say to bring him in immediately if he’s open mouth breathing. It just doesn’t seem to be a consistent thing, so I’m not sure what to do.

I gave him ¼-1/2c water around 1pm when we were posting about it, and he drank it all right away. He’s barely eaten today.

The vet was able to listen to his breathing and heart when we were there Friday—she said his heart sounded fine. She wanted to do x-rays to be sure he hadn’t aspirated when throwing up the daffodil.

I found a vet that does house calls, but they don't do x rays...

Right now I’m thinking I’ll check and see where he is when I get home. My plan is to drop him off tomorrow morning on my way to work and they can do the x-rays, etc while he’s there. But I’m still really hesitant about gassing him :sad:

I just talked with the vet...she said gassing him is safer for him bc no one will have to hold him down or anything. She advised against doing a sedation pill at home on top of that, because it will drop his blood pressure.

Why do I feel so iffy about gassing?!

Just what the vet mean by "gassing"?
Placing the cat in a box an introducing gas anesthesia into the box?
Or using gas anesthesia via an endotracheal tube?

Larry, from the way she describes it, I would say its placing the cat in a box and introducing gas anesthesia into the box

He got into some of my daffodils Thursday before last, but seemed to throw it all up almost immediately

Click to expand...

Daffodils are toxic to cats http://www.aspca.org/pet-care/animal-poison-control/toxic-and-non-toxic-plants/daffodil

I'm wondering if he's having some residual effects from ingesting the daffodils?

That can be stressful but it sounds like pill sedation will not allow them to use an injectable anesthesia drug. That happens sometimes.

Yes, Deb maybe so!
Larry, it is stressful! I loved your idea; I so wish it was feasible.

Here's an update since I've been home:
I walked in the door and was not greeted. That NEVER happens. I looked all over my apartment and couldn't find Sushi. This also NEVER happens. By this time I was in tears. I looked under the couch and there he was. Then I noticed a few stools right next to my hand; it's a wonder I didn't step in one of them or put my hand in one. Sushi left a myriad of stools all over the living room. While ordinarily this would be super annoying, I'm almost over the moon! That's 2 poops in one day! Woop! So I think he must have been dehydrated.

He didn't touch his breakfast, so I'm not sure if he's eaten anything today.

I then gave him some more water (~1/4c) while I checked his BG. His Nadir & PMPS haven't varied from his AMPS--still in the 420's.
He only drank about 1/2 the water (1/8c). Next, I tried mixing his steroid with some chicken & veggie baby food instead of force-feeding it to him. He ate it right up!
For supper, I tried making him a "soup" of canned 9 Lives, a tablespoon or so of baby food & lots of water. He's been working on it with some persuasion. We'll see.

There have been a few open-mouthed breaths, but for the most part he's breathing with his mouth closed.

So I guess I still plan to drop him off at the vet first thing in the morning.

hi ashley! i started to post on your other post on LL, but see all the posts here instead.

we have several cats with asthma. Melissa/Tarragon is a daily poster on LL and Tarragon has asthma.

Constipation is another issue that many cats have.

I'd guess you're seeing higher blood sugar because of the steroids. As others have said, if he needs the steroids to breathe, that trumps everything and you just adjust the insulin to compensate. My daughter's cat (not diabetic) had a brief flirt with asthma and she was able to work him off of the meds fairly quickly. i don't know that would be the case with Sushi, but it's a possibility. in any case, having him breathe comfortably is very important.

keep in touch! i'll be wondering how things go tomorrow.

ps - when you get a chance if you could update his ss, it's so much easier to get the pic of what's going on with his BGs.

what do you mean when you say you "gave him 1/4 cup of water" and he drank some of it. does he have water available to him all the time? or are you forcing it in him?

Also, please check he baby food you're giving Sushi. Baby food should be pure protein -- no veggies. And please make sure there is no onion or garlic in what you're feeding. They are not good for cats.

Hi Julie!!!
I don't typically leave water out. I add water to his food instead; prob 1/8-1/4c per feeding x 4 feedings a day. So I meant I put water out for him.

Oy Sienne I didn't know I couldn't give baby food with veggies! This flavor had the lowest # of carbs; that's why I went with it. Looks like it does have bit of onion powder in it... Sushi didn't eat much of it; maybe a few tablespoons. :?

onions are toxic to cats - i don't know how much would be too much. hopefully there wouldn't be much in there.

especially with him having constipation issues, i'd put a large bowl of water out for him that he can always get to. although most cats don't drink much plain water, some do, and diabetic cats are dehydrated. some people buy fountains to encourage their cats to drink more. i think that's one simple, very helpful thing you could do right away.

punkin would lay against his water bowl when he wasn't feeling well or his numbers were high. it was hard to see. but it said to me how important having the water always available was. i have a couple of old dog water bowls that i leave around the house.

how is he behaving tonight?