5/14 Bad Symptoms PMPS 458 +1 425, +2 350 (lowest num), +3 247 (lowest num),

Mookitty's Mom

Mookitty's Mom

Member Since 2022
@Bron and Sheba (GA)
@Wendy&Neko
@tiffmaxee
@Diane Tyler's Mom
@Hendrick Cuddleclaw
@Bandit's Mom


I don't know whether I can give Moo insulin or how much tonight.

She is having a really bad day. She was too lethargic to eat most of the day. I still ended up giving her a shot because I thought she hadn't had enough insulin from underdosing the night before. I ended up feeding higher carb food and doing syringe feeding to make sure she was safe. That was hours ago. I'd say she probably ate less than 1/5 of her normal amount.

She just threw up and my housemate didn't inform me till after the AM shot, but she also threw up this morning. She also just had diarrhea. I don't know what is going on, but I suspect it might be the original issue that put her in DKA in the first place.

I gave her between 50 and 70 ml of subQ fluids today. I can syringe feed but it won't matter if she doesn't keep it down. I tested 3 times for ketones and got the values 0.4 and 0.2 on a Precision Xtra Meter. The highest I've seen is 0.5 a few days ago.

She needs to see a vet but it is 2 a.m. currently and the vet doesn't open till 8.
 
Hi Ariah,
I’m sorry you and Mookitty are having a bad day and night. But it does sound as if you have been managing the problems very well.
That is really good you gave the dose of insulin and fed some higher carb food and syringe fed her. And really good no ketones.
Do you have any cerenia or ondansetron you can give her for the nausea/vomiting?
Where abouts in the cycle are you up to at the moment?
 
Unfortunately, I have nothing except mirtazapine. No antinausea stuff on hand for cats.

We are about 1 hour and 30 minutes from her shot.

All this time I've been thinking that maybe she was just fatigued from insulin, or had low appetite because she didn't receive enough insulin the night before, or was inappetence because of some late doses I've been having.

I've been reading about pancreatitis and I have to wonder.
 
I am wondering about pancreatitis as well. Lethargy, loss of appetite, vomiting, diarrhoea are all symptoms of pancreatitis.
Keep trying to get her to eat….anything at all…don’t worry if it is low carb or high carb. Try anything she likes. If necessary syringe feed. I would just do small amounts as much as she can tolerate.
We will aim to give her the dose of insulin when it is due. It looks like the BG will he high.
And I would take her to the vet as early as you can…….will they see you if you just turn up in the doorstep?
Ask for a fPL snap (normal done in house and will tell you yes/no to pancreatitis, or an fPL spec which has to be sent off site and will give you a number.
Treatment for pancreatitis is pain medication, antinausea injection and then ask for some antinausea medications (cerenia or ondansetron) to take home and subQ fluids which you are already doing.
 
Should I try to get her to eat this close before testing her before insulin?

Usually, they ask that you call repeatedly at 8:30 a.m to see if an opening is that day if you do not call on the emergency line. I'm assuming they would see me tomorrow if I say it's an emergency. At the very least, I couldn't imagine them not giving some antinausea medication to take home.
 
Mookitty's Mom said:
No, I was giving her a break after I realized the bg was going up. I could do one now though.
Click to expand...
If the BG is still high, I can’t see any reason why you can’t give her a small amount to eat. We say don’t feed for the 2 hours preshot because when you are new, we don’t have data. But I can see she is high at the moment and I think it is important we try and get her to eat some food.

I would be most surprised if the vet would not see you immediately given that Mookitty is a diabetic cat with a recent history of DKA and her current symptoms. It would be negligent of him if he didn’t see her. She will need an injection of antinausea medication first up as she would most likely vomit any oral meds at the moment.
 
She didn't eat much but its 1.3kcal a piece. The carb amount is probably high. If i take the values for everything else (protein, fat, fiber, moisture) there is about 50% which is likely mostly carb. The third ingredient is brewer's rice. My dad bought it for hypoglycemia. It isn't supposed to be food. They say don't exceed 10 treats a day but I'm wondering if that's for avoiding weight gain and the lack of nutrition... I think its better than nothing.

She has 20 or so minutes before her shot. Should I syringe feed or attempt to before then? The nibbling was not that impressive with the treats.
 
It would be good to get some food into her before the shot if you can. We don’t want to make her vomit though. you will have 2 hours before onset to try and get some more food into her. I would test now though so you have the Preshot before the food,
 
I'll be up till its time to call the vet.

Syringe feeding goes terribly. She tries to get away and I don't get much in her. A lot ends up on a towel.
 
I didn't bring this up before but although the cat is mine Im currently living with my father. He is really mad I gave the full dose and tends to give unsolicited advice. I've been dealing back and forth with a lot of arguing for a year on things as simple as taking her to the vet. I'm dealing with that also right now.


My environment is extremely unsupportive.
 
Mookitty's Mom said:
I didn't bring this up before but although the cat is mine Im currently living with my father. He is really mad I gave the full dose and tends to give unsolicited advice. I've been dealing back and forth with a lot of arguing for a year on things as simple as taking her to the vet. I'm dealing with that also right now.
My environment is extremely unsupportive.
Click to expand...
I am so sorry you are dealing with this. It must be very difficult not having support around you.
You are doing a really good job looking after Mookitty. Don’t let anyone tell you otherwise. It is obvious you have Mookitty’s best interests at heart. Just keep posting here so we can suppport you. It’s really important you are getting support from somewhere, even if it is not at home.
I will be heading to bed before too long so I am going to tag @Bandit's Mom to ask her to pop in and say hello and answer any questions or queries.
Post the BGs so we can see how it is going and let us know how the syringe feeding is coming along.
And please let us know how you get on at the vet.
 
oh poor Mookitty and I hope she feels better soon! Sorry to hear of the situation at home Ariah, that sounds super difficult and mentally exhausting. I give you a lot of credit for hanging in there and doing your best for Moo.
 
So sorry to read this about your kitty. It does sound like it’s pancreatitis. It’s so common with cats and vets are finally realizing this. I found ondansetron worked really well for nausea, even better than cerenia but like Bron said get a shot today. I’d ask for an RX for ondansetron. I used to often get it at Costco.
 
She is in cerenia now but still barely eating. It is pancreatitis. I haven't given the second shot yet because i cant syringe feed her right now. I tried but i cant get her to open her mouth. Im not okay at all. Not composed at all and I dont have faith in my ability to chase her blood sugar down like this. She is eating minute amounts of treats but i cant trust what that will do to her bg. I have horrible thoughts of giving up.

There is no way i can give 0.9
 
Have you tried ondansetron? It worked really well for Max who had chronic pancreatitis. It’s often better for nausea than cerenia.
 
Have you checked for ketones? Her bg is pretty high. Do you have honey or karo? I would not feel comfortable withholding insulin with her bg that high and previous dka.
 
Did they give any pain medications? Pancreatitis is very painful and they need pain meds.
Please keep posting and we can help you. There will be someone here to help you all the time.
I understand how you feel but remember we all understand here and support you 100%. please don’t give up.
Pancreatitis is a very treatable illness.
I agree with Elise…..can you ask the vet for some ondansetron and also pain meds if they haven’t given you those.
Just a bit of information about insulin which may help……..it is needed for more than just the pancreas as it does other things in the body…..and when diabetic cats have to fast for an operation, they are given a half dose of their insulin …….so it is OK to give some insulin even if they are not eating.
How are the ketones going ?
But we really need to make sure Moo keeps eating some food….and keeps getting insulin. So please chase up the ondansetron and the pain meds. we are here for you:bighug:
 
tiffmaxee said:
So sorry to read this about your kitty. It does sound like it’s pancreatitis. It’s so common with cats and vets are finally realizing this. I found ondansetron worked really well for nausea, even better than cerenia but like Bron said get a shot today. I’d ask for an RX for ondansetron. I used to often get it at Costco.
Click to expand...
They recommended cerenia for how long-acting it was but said they could prescribe ondansetron but didn't at the time i visited. They gave the shot and some pills for cerenia. Vet will be closed tomorrow (Sunday) till Monday.
 
tiffmaxee said:
Have you checked for ketones? Her bg is pretty high. Do you have honey or karo? I would not feel comfortable withholding insulin with her bg that high and previous dka.
Click to expand...
Ketone was 0.3 after a very long delay in her insulin dose. The highest it has been (not today) has been 0.5. This is with a precision Xtra meter. I'll keep monitoring.
 
Many of us find that ondansetron works better for nausea and some cats need both cerenia and ondansetron. They work differently. Did they run a test for pancreatitis? Max always had nausea as the first sign of a flare. Sometimes he needed buprenorphine for pain and occasionally with a bad flare sub-q fluids. Once you learn what works for Moo it will get easier. :bighug: One thing Max would eat when he turned down everything else was Gerbers 2nds 100% protein baby food. It doesn’t contain garlic or onion. Most cats love it. The ham was a favorite. It’s easy to finger feed too.
 
Bron and Sheba (GA) said:
Did they give any pain medications? Pancreatitis is very painful and they need pain meds.
Please keep posting and we can help you. There will be someone here to help you all the time.
I understand how you feel but remember we all understand here and support you 100%. please don’t give up.
Pancreatitis is a very treatable illness.
I agree with Elise…..can you ask the vet for some ondansetron and also pain meds if they haven’t given you those.
Just a bit of information about insulin which may help……..it is needed for more than just the pancreas as it does other things in the body…..and when diabetic cats have to fast for an operation, they are given a half dose of their insulin …….so it is OK to give some insulin even if they are not eating.
How are the ketones going ?
But we really need to make sure Moo keeps eating some food….and keeps getting insulin. So please chase up the ondansetron and the pain meds. we are here for you:bighug:
Click to expand...
They gave her a small shot of pain medication while there but didn't send me home with it. They did not detect any clear signs of pain. During this, I've often been petting her on the stomach and she seems to still enjoy it. It is unclear what she is feeling.

I'll ask for ondansetron Monday and about the pain meds. I did ask about all of these things earlier.

I gave a tiny amount 0.3 because I was scared. Last time when I gave 0.9 the syringe feeding was working. As far as eating goes she had a brief stint where she ate quite a bit about 2 hours before her shot. About ~130 calories of treats. That's all she will eat. Her ketones were 0.3 after her insulin delay. They have been 0.5 before.
 
Just so this is in one place because I'm answering questions and I'm losing track of all I've responded to -
Insulin: I gave 0.3 (1/3 her dose approximately) because I was too afraid of my not being able to syringe feed.

Ketones: Her ketones were at 0.3 most recently after a very long delay in her insulin shot. They have been 0.5 when she was doing better before. I have a precision Xtra monitor that I can use to inform dosing on the next cycle.

Diagnostic Values Relevant to the Pancreatitus:
* Her fPL snap was abnormal
* ALT 460 U/L [reference range 12 -130] (liver)
*ALKP 192 U/L [reference range 14-111] (liver)
* GGT 14 U/L [reference range 0 - 4] (liver)
They think the heightened liver values are caused by the activity occurring the pancreas because of the proximity.

Treatment Plan I was sent home with:
* 100 ml of fluids every day
* a shot of Cerenia today and 1/2 a pill every day starting tomorrow
* mirtazapine (topical)
* a shot of pain med (small) because the vet didn't detect clear signs of pain

Her state right now:
* ate a little bit more (still only going for junk food)
* drank a lot
* sitting on the couch and purring

Plan moving forward:
* keep watching food intake
* check her ketones before next cycle
* keep monitoring bg
* ask for the other antinausea medication and pain meds Monday. The vet is closed Sunday and its 7:50 p.m where I'm at.
 
That’s a great summary thanks Ariah.
With the appetite stimulant, make sure she has had the anti nausea meds first.
That’s fine she is only eating junk food for now…if that is all she will eat, that is OK. The most important thing is she eats.
I would be happier if you could go back to the 0.9 dose next cycle.
 
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