? 8/9 Buddy not eating, post DKA

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DArcey and Buddy

DArcey and Buddy

Member Since 2020
Starting a new thread, precious thread can be found here: https://www.felinediabetes.com/FDMB/threads/please-help.250982/page-2#post-2832346

@Chris & China (GA) I hope I have done the title properly

@Bron and Sheba (GA), @Juls and Billy and @JanetNJ thank you all again for your help yesterday. I hope it’s okay that I’m tagging you so you’ll see this new thread.

Buddy is doing okay so far today I think. She dropped quickly between +2 and +3, but it’s seems to have slowed at +4.

My concern at the moment is that she isn’t as eager to eat as she was. In the last four hours, including shot time, she’s eaten 2/3 of a can of her regular fast feast, and that’s it. When I bring food to her, she will have a bite, which is good, but I’m still a bit concerned. She does seem quite tired/lethargic. I tested blood ketones, and they are currently at 0.0, so I’m trying to stay calm. We both got some much much needed sleep!

I’m a little worried she should be nauseous. Yesterday we gave her an appetite stimulant, mirtazapine. The only was we have success getting pills in her is in her food, and she only ate half of the food. I forced a little bit more of it into her, but I believe she only got 1/2 to 2/3 of the pill into her, and it was her first one in 72 hours. If she really starts to slow down in her eating, would it be safe to force feed her 1/4 of a pill today, to keep her eating? We don’t have anti nausea meds, which I’m furious about. The emergency vet told us it wasn’t necessary. We are pretty sure we can see our regular vet tomorrow, and I plan to beg her for anti nausea, as well as additional pain meds and appetite stimulant pills. With a severe cases of pancreatitis, I really really feel we need to have these things on hand.
 
D'Arcey Taylor said:
Starting a new thread, precious thread can be found here: https://www.felinediabetes.com/FDMB/threads/please-help.250982/page-2#post-2832346



I’m a little worried she should be nauseous. Yesterday we gave her an appetite stimulant, mirtazapine. The only was we have success getting pills in her is in her food, and she only ate half of the food. I forced a little bit more of it into her, but I believe she only got 1/2 to 2/3 of the pill into her, and it was her first one in 72 hours. If she really starts to slow down in her eating, would it be safe to force feed her 1/4 of a pill today, to keep her eating? We don’t have anti nausea meds, which I’m furious about. The emergency vet told us it wasn’t necessary. We are pretty sure we can see our regular vet tomorrow, and I plan to beg her for anti nausea, as well as additional pain meds and appetite stimulant pills. With a severe cases of pancreatitis, I really really feel we need to have these things on hand.
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I order Mirataz appetite stimulant from Chewy for my kitty. It is transdermal so I do not have to pill him.
 
Ann & Sister said:
I order Mirataz appetite stimulant from Chewy for my kitty. It is transdermal so I do not have to pill him.
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Oh!! This is soooo good to know! Looking into this right now! Just curious, does your cat deal with pancreatitis?

I’m also relieved to say that I called the emergency vet and begged for some cerenia, and they allowed it. Thank god. We need to keep her eating.
 
Also Chris had asked that I edit the title of this post to include updated information but I cannot seem to figure out how to edit the title, if anyone has any tips!!
 
D'Arcey Taylor said:
Oh!! This is soooo good to know! Looking into this right now! Just curious, does your cat deal with pancreatitis?

I’m also relieved to say that I called the emergency vet and begged for some cerenia, and they allowed it. Thank god. We need to keep her eating.
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No, my kitty does not have pancreatitis. He has a "congenital" condition where his digestive system is bonkers (surgery last September modified it so he could live).
So I get the Mirataz for times where his abdominal situation causes more discomfort than the Cerenia can relieve. Restores his appy and assists further with nausea.

Marje taught me to modify the post title. You click on the ThreadTools button (upper right) within your post. It takes you to an Edit area.
 
Ann & Sister said:
No, my kitty does not have pancreatitis. He has a "congenital" condition where his digestive system is bonkers (surgery last September modified it so he could live).
So I get the Mirataz for times where his abdominal situation causes more discomfort than the Cerenia can relieve. Restores his appy and assists further with nausea.

Marje taught me to modify the post title. You click on the ThreadTools button (upper right) within your post. It takes you to an Edit area.
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Thank you, the edit worked!

Just curious, how much mirataz did you give and how often? Buddy isn’t eating much today still, so I’m trying to figure out if/when I might be okay to give her a bit more of it. I will do some research as well but any advice/experience is always helpful :-)
 
D'Arcey Taylor said:
Just curious, how much mirataz did you give and how often? I will do some research as well but any advice/experience is always helpful :)
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I rarely give it to him these days. Usually the 1/4 Cerenia tablet does its job within 2 hours. Only when it does not (he vomits again or it does not seem to be digesting) do I put Mirataz on the inner ear flap to help with appy and nausea (since I cannot give more Cerenia). The dose was about an inch long, squeezed out of the tiny tube. Med keeps pretty long. Does not dry up like my transdermal Gabapentin.
Hugs,
 
I changed the name of this thread. We are approaching shot time and Buddy has barely eaten today.

@Chris & China (GA) @Juls and Billy @JanetNJ @Bron and Sheba (GA)

I begged the emerg vet for cerenia today to offset any nausea. We have given her 8mg cerenia. We also have her 1mg of mirtazapine. We tried giving her a 2mg mirtazapine pill yesterday, ground up in her food, but she only took down half the food, so only got about 1mg of it yesterday. Today we spend the day figuring out a different way to pill her, so we know the cerenia and the 1mg mirtazapine was definitely swallowed today.

Her number did not go too low today despite her not eating much, but she normally goes lower at night than during the day. In the morning she ate close to half a can of fancy feast, but has only taken a few bites since then... even with the cerenia and appetite stimulant. I am still praying that they are going to help, but will need advice for tonight... how much insulin do we give if she is not willing to eat/barely willing to eat? We are available to monitor and we can syringe feed, but she seems to really hate syringe feeding so I’m just not sure how much we would be able to reliably get into her that way. I am reading tips now though.

Thanks in advance
 
Hi D’Arcey
I’m glad there are no ketones…that’s great!
I’m sorry she is not very hungry. Maybe she has had a lot over the last couple of days.
I’m glad you got the cerenia. If you get a chance to get some ondansetron from your regular vet, get some of those as they are often better for nausea than cerenia and they can be given up to 3 times a day and can be given at the same time as the cerenia.

In regard to the food, at this point, if she is not wanting the fancy feast, offer her any other food. It doesn’t matter if it is not low carb. We just need her to eat and eating trumps everything else. So even dry food is ok…..we don’t like it ….but the most important thing is she does eat. We can go back to the low carb when her appetite improves. It is not u common to have cats recovering from DKA who need to be offered other foods to get them to eat. When Sheba had pancreatitis, I sometimes had to give her some dry food to get her to start eating again.

If you are able to syringe feed (if absolutely necessary) I think we should give her the full dose of 1.75. If you are not comfortable with doing that, than give 1.50.
See if anyone else comes along to add to this.

Stimulating kitties appetite link here
 
Bron and Sheba (GA) said:
Hi D’Arcey
I’m glad there are no ketones…that’s great!
I’m sorry she is not very hungry. Maybe she has had a lot over the last couple of days.
I’m glad you got the cerenia. If you get a chance to get some ondansetron from your regular vet, get some of those as they are often better for nausea than cerenia and they can be given up to 3 times a day and can be given at the same time as the cerenia.

In regard to the food, at this point, if she is not wanting the fancy feast, offer her any other food. It doesn’t matter if it is not low carb. We just need her to eat and eating trumps everything else. So even dry food is ok…..we don’t like it ….but the most important thing is she does eat. We can go back to the low carb when her appetite improves. It is not u common to have cats recovering from DKA who need to be offered other foods to get them to eat. When Sheba had pancreatitis, I sometimes had to give her some dry food to get her to start eating again.

If you are able to syringe feed (if absolutely necessary) I think we should give her the full dose of 1.75. If you are not comfortable with doing that, than give 1.50.
See if anyone else comes along to add to this.

Stimulating kitties appetite link here
Click to expand...

This all sounds good to us, and thank you for the advice. You are amazing!

She has just willingly eaten a bit of her regular food. Not a lot, but some- maybe 1/4 of a can max. I agree- I think we should give the full dose. We will be monitoring her all night, and we are preparing to syringe feed as needed. We watched a video on it that really calmed me down and gave me some confidence, and I’ve prepared the syringe just in case!

Since she is eating a bit of her normal food now, I will not offer the higher carb wet or the the dry food yet, but we have it and will use it as needed too. We used a few higher carb treats to “pill” her today, and she was very eager to eat those, so she is not turning away from food entirely, though she isn’t getting enough in. If busy doesn’t start eating more in the next hour or two, we will start giving a syringe of food as needed to get the nutrition into her!
 
D'Arcey Taylor said:
Okay, good idea. Would that include dry food, or just higher carb wet food for now? I just pulverized some dry food to use as a topper to try and entice her to eat, lol
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What ever she will eat is OK at the moment. The most important thing is, she eats. If you need some dry to entice her, that is OK. The BG might be a bit higher but we will know why. Put in the remarks column what you are feeding her.
 
Bron and Sheba (GA) said:
What ever she will eat is OK at the moment. The most important thing is, she eats. If you need some dry to entice her, that is OK. The BG might be a bit higher but we will know why. Put in the remarks column what you are feeding her.
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Okay sounds good! I am sticking with medium carb wet topped with a bit of dry, and she has her normal low carb available to her. And of course she gets offered breakfast in bed, where I bring food to her every hour, should she wish to eat without having to get up... lol
 
D'Arcey Taylor said:
Okay sounds good! I am sticking with medium carb wet topped with a bit of dry, and she has her normal low carb available to her. And of course she gets offered breakfast in bed, where I bring food to her every hour, should she wish to eat without having to get up... lol
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Sounds like a great hotel! Great room service!
Every hour may be a bit soon. If she eats OK I would wait two hours.
 
She is still pretty high, 277 at +4. On the bright side, I’m glad to see her BG isn’t plummeting at the rate it was yesterday:
 
Bron and Sheba (GA) said:
How is she eating now?
How are the ketones today?
Why are there two lines of the BGs in the SS?
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]@Bron and Sheba (GA)[/USER] so sorry for the late reply, we had to catch a nap once her numbers started going up! Thanks for asking all this!!! :)

Blood ketones are at 0.3 this morning. She is eating okay. Not great and not her normal amounts at the moment, normally she’s a big and enthusiastic eater. I’m definitely worrying like crazy. She ate a little bit of her normal fancy feast with my hubby at shot time. When I got up a half hour later I wasn’t happy with the amount she’d eaten so I basically just started opening cans, and she ate some of one of them. I think it’s higher carb, but I don’t know how high, it’s a grilled salmon with spinach in “sauce”. But at this point, I want her eating. Her energy seems low, and I want food in her, and she doesn’t seem into the “topper” of dry food or fortiflora or tuna juice tricks at the moment.

So sorry about the spreadsheet. Something we did in the night accidentally caused a very odd error. Hubby is working on fixing it now and updating it now. I didn’t want to mess with the formulas during the night with my exhaustion. Sorry for the confusion though!!
 
D'Arcey Taylor said:
Follow up to my above post, after a half hour of carefully going though the SS we believe we have all the formulas fixed and it’s working properly again.
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Just getting up in my part of the world!:cool:
The SS all looks ok to me and I see she is back down in blues again.
I think she is doing really well in her recovery, so I want you to try and not worry so much……..I will tell you when to worry…how about that?
If there are no ketones in the picture (and I don’t mean the 0.2 or 0.4 you sometimes get….I mean 2.4 and above) than we have the insulin dose and food amounts about right. They might need tweaking at times but so far, so good!
 
Bron and Sheba (GA) said:
Just getting up in my part of the world!:cool:
The SS all looks ok to me and I see she is back down in blues again.
I think she is doing really well in her recovery, so I want you to try and not worry so much……..I will tell you when to worry…how about that?
If there are no ketones in the picture (and I don’t mean the 0.2 or 0.4 you sometimes get….I mean 2.4 and above) than we have the insulin dose and food amounts about right. They might need tweaking at times but so far, so good!
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That sounds amazing to us. Thank you so much.

ooh, what part of the world are you in? We are in Ottawa Canada :-)

She is eating decently today. Her BG was in the black for her PMPS, which we just gave, and blood ketones are at 0.9 but we are trusting that it will be okay, as you said, and not panicking anymore!!! These may be “normal” level of ketones for her, so we will keep tracking just so we have a good sense of her normal range going forward, but will be practicing calming thoughts and deep breathing and are confident in the help we are getting here and that you will tell us when there is cause for concern. Thank you again!!

By the way- this morning we fed some high carb food, and after that, like almost right after, she was eager to eat her normal low carb food again! It just goes to show that getting some food in her stomach probably made her feel better, which made her more eager to eat as normal again. Celebrating these small victories!
 
I’m glad Buddy is eating well today. That’s good news. Yes, often if you can get them to start eating, they will continue.
How is her demeanour?
Those higher preshot numbers might just be lack of duration because she is coming down during the cycles but not staying down until the next shot. But looking back on the SS she almost always had higher preshots, even when she was going down to greens during the cycles.
I might ask @JanetNJ what she thinks about increasing the dose to 2 units tomorrow if Buddy doesn’t drop into greens overnight. I’m not a Prozinc user so would rather have her opinion on this one.
Don’t forget to put the ketone results in the SS please!

I live in Sydney, Australia. That is why I am usually online during your evening and night time.
So can I ask what your name is please. I know there is D’Arcey, but there are two of you, right?
 
Bron and Sheba (GA) said:
I’m glad Buddy is eating well today. That’s good news. Yes, often if you can get them to start eating, they will continue.
How is her demeanour?
Those higher preshot numbers might just be lack of duration because she is coming down during the cycles but not staying down until the next shot. But looking back on the SS she almost always had higher preshots, even when she was going down to greens during the cycles.
I might ask @JanetNJ what she thinks about increasing the dose to 2 units tomorrow if Buddy doesn’t drop into greens overnight. I’m not a Prozinc user so would rather have her opinion on this one.
Don’t forget to put the ketone results in the SS please!

I live in Sydney, Australia. That is why I am usually online during your evening and night time.
So can I ask what your name is please. I know there is D’Arcey, but there are two of you, right?
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oh yes, I will go add the ketone values now. Sorry bout that!

In terms of her demeanour, she is lower energy than usual, but in decent spirits. When we hold her, she purrs. She seems to be handling all the pills/tests/fluids well. I’d love to see her with a bit more energy, as she is pretty tired. She is also dealing with some neuropathy since she got home which she never had before. But she still walks around, and jumps up onto the couch and the bed. I’m hoping she will start regaining energy so my fiery redhead will come out again! But, she is also on gapapentin 3 times a day and 0.1 mg buprenorphine 3 times a day, which may be making her a little sedated.

Yes! I am Jess & the hubby is D’Arcey. We can sign our posts with our name if that would be helpful to know who is typing! I am way more neurotic, anxious and long winded, and he is more chill and to the point, lol.

I was in Sydney for a week in September 2010 - beautiful city. Loved exploring Australia, I was lucky to spend 6 week on the East Coast.

Jess
 
Bron and Sheba (GA) said:
I’m glad Buddy is eating well today. That’s good news. Yes, often if you can get them to start eating, they will continue.
How is her demeanour?
Those higher preshot numbers might just be lack of duration because she is coming down during the cycles but not staying down until the next shot. But looking back on the SS she almost always had higher preshots, even when she was going down to greens during the cycles.
I might ask @JanetNJ what she thinks about increasing the dose to 2 units tomorrow if Buddy doesn’t drop into greens overnight. I’m not a Prozinc user so would rather have her opinion on this one.
Don’t forget to put the ketone results in the SS please!

I live in Sydney, Australia. That is why I am usually online during your evening and night time.
So can I ask what your name is please. I know there is D’Arcey, but there are two of you, right?
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Quite a big drop by +2. She started at 520 (28.9) and at +2 she is at 302 (16.8).

She is having a low carb snack of her regular food and we will get a +3 test, unless we should be getting a +2.5.
 
D'Arcey Taylor said:
Quite a big drop by +2. She started at 520 (28.9) and at +2 she is at 302 (16.8).

She is having a low carb snack of her regular food and we will get a +3 test, unless we should be getting a +2.5.
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Yes that is quite a drop. 200 points in 2 hours.
I’m glad you gave some food. I think I would give her some higher carb food to slow that drop down. Not too much. Just a teaspoon full.
 
Bron and Sheba (GA) said:
Yes that is quite a drop. 200 points in 2 hours.
I’m glad you gave some food. I think I would give her some higher carb food to slow that drop down. Not too much. Just a teaspoon full.
Click to expand...
At +3, she is at 209 (11.6). So she is still dropping about 100 points an hour. Should we give a bit more high carb food, or wait a bit? We are going to get a +3.5 test.
 
I would just give her normal low carb now if she needs it, or just not feed for an hour and see how she goes. We don’t want to fill her up too much in case we need her to eat around nadir.
I would colour the +3 square blue as we always colour it the lowest reading in the square.
Would love to see a photo of her sometime.

D'Arcey Taylor said:
I was in Sydney for a week in September 2010 - beautiful city. Loved exploring Australia, I was lucky to spend 6 week on the East Coast.
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Hi Jess!
Am glad you liked Sydney. We love living here. Very relaxed city. We are only 11 km from the centre of the city but live in a forested area with lots of wildlife and only 10 minutes to the beaches.
I’m partial, but think the east coast is the best.;)
 
Bron and Sheba (GA) said:
I would just give her normal low carb now if she needs it, or just not feed for an hour and see how she goes. We don’t want to fill her up too much in case we need her to eat around nadir.
I would colour the +3 square blue as we always colour it the lowest reading in the square.
Would love to see a photo of her sometime.


Hi Jess!
Am glad you liked Sydney. We love living here. Very relaxed city. We are only 11 km from the centre of the city but live in a forested area with lots of wildlife and only 10 minutes to the beaches.
I’m partial, but think the east coast is the best.;)
Click to expand...

Perfect, just changed the square to blue!

Just did a +4 test, and she was at 166 (9.2). We will hold off on food for the time being and see how she does. It seems like the drop has definitely slowed down to a safer speed but we are gonna keep monitoring it till we are sure & till she starts going up.

Where you live sounds so lovely! I wish we could live near the ocean, but it’s hours and hours away from us - like 12+ hours to the East, and like a 4-5 day drive to the West! Haha. But Lake Ontario is huge and beautiful and only 3 hours away.

I will definitely upload a picture at some point soon- just have to figure out how!
 
D'Arcey Taylor said:
Just did a +4 test, and she was at 166 (9.2). We will hold off on food for the time being and see how she does. It seems like the drop has definitely slowed down to a safer speed but we are gonna keep monitoring it till we are sure & till she starts going up.
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Yes, she is slowing down…..
D'Arcey Taylor said:
I will definitely upload a picture at some point soon- just have to figure out how!
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At the moment the best way to upload a picture is to copy and paste. The “upload a file” option is not working atm.
 
Bron and Sheba (GA) said:
Yes, she is slowing down…..

At the moment the best way to upload a picture is to copy and paste. The “upload a file” option is not working atm.
Click to expand...


Here she is:

upload_2021-8-10_3-4-48.jpeg
 

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Bron and Sheba (GA) said:
Yes, she is slowing down…..

At the moment the best way to upload a picture is to copy and paste. The “upload a file” option is not working atm.
Click to expand...
At +5 she is at 169 (9.4), so it seems like she is on her way back up now. We will get a +6 as well just to be sure, and then will probably check every 2 hours just to see what her numbers to the rest of the time, for our records. Interesting to see that she went down so quick but didn’t go very low. I only gave her a total of two tsps of high carb food total, and otherwise she can only eaten her normal low carb food!
 
D'Arcey Taylor said:
Interesting to see that she went down so quick but didn’t go very low. I only gave her a total of two tsps of high carb food total, and otherwise she can only eaten her normal low carb food!
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That was enough to slow her down a bit. Hopefully she won’t go up too high next cycle and then maybe she will come down more sedately. but she could bounce.
 
Bron and Sheba (GA) said:
That was enough to slow her down a bit. Hopefully she won’t go up too high next cycle and then maybe she will come down more sedately. but she could bounce.
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Aw thank you so much! We think so too! She’s the love of my life!

At +6 she is down a tinnnnny but again, but only to 162 (9). Time will tell if she goes down a bit more or goes up now. Because she’s going down a bit we will get a +7 as well!!
 
I think I'd keep this dose another couple days before going back to 2. Going down to 108 was a pretty good drop, then it bounced up. I'd like to see what this dose does before raising right away.
 
@Bron and Sheba (GA) @JanetNJ @Chris & China (GA)

Another possibly silly ketone question, sorry for still not 100% understanding. Since Buddy has been home from the hospital, we have been testing both her blood and urine for ketones. Urine tests have all been negative, and the blood ones have ranged between 0.0 and 0.9. We just tested her urine, and got our first “trace” urine ketone result. I tested her blood ketones and it said 0.3 which I know is not cause for concern. I am just curious why it would suddenly be showing as trace in her urine, though. Is one (urine or blood) considered to be more accurate than the other?

Sorry for the constant questions and concern, we are just trying to stay super on top of this, and do everything we can to prevent another emergency/another hospital stay.
 
Chris & China (GA) said:
Did you "read" it at exactly 15 seconds? The longer it sits after 15 seconds the darker it gets. Also, the type of light you're using can make it look darker.
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Yes, we read it at exactly 15 seconds in good light. We did a second dip test with another urine stick right after to confirm, and it read as trace as well.
 
Did they send you home with fluids and show you how to give subq fluids?

As long as they stay at trace and don't go higher, the best thing you can do is get as much water into her as possible to help flush them out.

Is she still eating OK?
 
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