HELP!!Sudden poor appetite

UPDATE: with no advice for what dose to give, I went ahead and gave her 0.5u. I just couldnt keep waiting and I kept reading that she needed insulin even tho she didnt eat much.
UPDATE: At +42.5 she finally went to 203. She ate a little bit more kibble about and +41, a couple of bites about an hour after vomiting.
UPDATE: At +40.5-Ketones test look negative.
UPDATE: At +35.5 she was at 138. This is time was her scheduled test, feed, shoot. I got her to eat a little more food than she has in the last 35 hours. I did not shoot. I tested an hour and a half after food, +37 188.

Hello!
So candi started barely eating last night. I thot it was cuz of the flavor of the ff pate so I switched her to the other flavor and she ate a little under half of the half a can. This morning she ate 2 bites of the ff I had left over in the fridge(I heat it up everytime and make sure it's not too hot) and ran off. I felt I couldnt give her insulin because she simply did not eat enough. 12 hours later her appetite is still not there. She ate a couple of bites of it and was done again. This is not normal for her. Usually about an hour prior to meal times shes constantly hounding me. This morning and this evening she was not hounding me at all.
Tonight after she didnt eat much of her wet ff and doesnt even want her kibble either, got her to eat a friskies delectable bisque lickable treat for seniors 15+. She sneezes alot and she on an antibiotic clavamox drops for her POSSIBLE infection. This morning her bg was 230. I gave no insulin because the vetsulin tends to hit her hard from the bg readings. With no insulin since last night her evening bg was 222 and barely eating. I posted on fb version and they told me to shoot at 200 2 hrs after I was suppose to give her the insulin. Well I decide just incase to check her BG to make sure she was still at 200 before I gave her the shot and it had went down, significantly to 169. I waited and tested about 30 mins later and it was at 143. This I feel is a good sign 28 hrs without insulin from what the others have said.
-If she is 200+ should I shoot tomorrow regardless of food?
-If so, what dose?
-Should I also stop the antibiotic since there is a possible infection? (The vet keeps saying she will be okay and it's most likely viral but I feel they put her on the antibiotic to shut me up)

https://docs.google.com/spreadsheet...xpr0xjz2tiX8UyJM3SQA2daxhA8/edit?usp=drivesdk

Thanks in advance!
Candi & Becca

 

It is very hard to advise you about dosing without a spreadsheet.
If she is not eating I would definitely test for ketones in the urine. You can do this by buying a bottle of Ketostix from Walmart or a pharmacy and collecting a urine sample and dipping the test strip into the urine and reading the results against the colours on the side of the bottle exactly 15 seconds after dipping it in the urine.

The BG is probably dropping because she is not eating.
Not eating and no insulin and a possible infection or inflammation is the recipe for DKA so I would get those Ketostix and test for ketones.
I would also speak to your vet she could possibly have pancreatitis.

.

 

https://felinediabetes.com/FDMB/forums/spreadsheets-tech-support-testing-area.6/

Instructions for setting up your spreadsheet
If you have trouble we have 2 members that will set it up for you, just post and ask
Like Bron said without a SS and seeing her BG members do not feel comfortable giving dosing advice

 

This spreadsheet is your best defense against this disease. Please take advantage of it. IF you are having trouble setting it up, we have very good people who will help you with it. (I know I would need help)

 

Wait! It's in my signature! The C is the link!

 

My SS is in my signature!

 

It's the C in my signature. You guys said the link was too long so I re-did it and that's what it did.
https://docs.google.com/spreadsheet...xpr0xjz2tiX8UyJM3SQA2daxhA8/edit?usp=drivesdk

 

Ahhh ok I "C" If you can highlight that it would be helpful to everyone.

 

It's in my signature!

 

I've tried...it wont let me. I really really need help!

 

Its sunday and my vet is closed

 

You guys already said it was too long, I've tried to go what you have asked. I really need help on a dose!

 

@Chris & China (GA)

 

its ok .
I'm looking for help for you hold on.

 

I'm really sorry I'm in a time crunch..‍

 

no sorry necessary hold on

 

try here while you are waiting:
Suggestions on How to Stimulate Kitty's Appetite

 

@JanetNJ

 

Thank you

 

Antibiotics can throw appetite off. But youre going to need prescriptions to combat that. I dont know how feasible it is to go to the ER for new scripts

 

lol thank me when help comes

 

Becca you can always add the word HELP to your title.

 

Thank you..but This is why I stayed up extra last night so I would have answers this morning ..I'm just goin to stop the abtibiotic.

 

well if shes sneezing she probably needs it Is she still sneezing?

 

Sometimes there just arent people around . Sadly you got stuck with me. I havent had a diabetic kitty since 2010.

 

It's not that. So I just took her BG and it is 138 from 143 last night.

 

wow no insulin? Thats not half bad. I think tags arent going through.

 

Well I obviously will not shoot. How long should I wait to test after shes eaten to see if I should shoot you think?

 

I think 30 mins. (NOT an expert here)

 

No food + infection + no insulin is a recipe for ketones to develop. The antibiotic may be upsetting her stomach. Try giving her tuna, or fresh chicken or anything she will eat. If that doesn't work try hand feeding. If that doesn't work, water down pate food and syringe feed into her nouth. I would definitely check for ketones as well.

 

I think you can remove the 911 just add the word HELP

 

Geeze I forgot about ketones sigh thank you Janet

 

So shes definitely trying to eat more than the last 36 hours. And shes +36 138. There is a PROBABLE infection. Like I said I think they did it to shut me up. Because that was the third time she has had blood I her nose and they kept saying its viral.

 

whew maybe just an upset tummy but PLEASE try to get a ketone test. Do you have ketostix?

 

I do. I have bought some relion. I'll have to wait til she goes to the bathroom again.

 

You want to get your pre-shot test before food. Then, if you decide she's high enough to shoot, you feed, wait 30mins, then shoot.

I'm glad her appetite is starting to pick back up!

 

Keep a close eye on her to catch her in the Litter box

 

The 138 is amps...but shes been without insulin for 36 hours. I was asking INCASE the food spiked her bg. If I should test after food.

 

I had a kitten with pneumonia. Keep that nose moist. Try putting her in a bathroom with a steamy shower, or a vaporizer. I also did nebulizer treatments by putting her in a carrier and covering it, then putting the end of the nebulizer in the front grate.

 

Food should spike her numbers. Dont know how high but thats what food does.
I dont think one can test too much. I mean within limits.

 

Oh, I see...

Is she just eating her usual low-carb food right now? If so, I wouldn't expect a big food spike (never say never...). If you skip this shot too, I'd just keep getting another couple tests in today.

I'm also very worried about ketones, but I really don't think that you want to shoot 1.5U of Vetsulin into a cat with an iffy appetite with a 138 (AT2 reading) pre-shot (disclaimer: I am not a Vetsulin person). That's basically a normal BG number!

Even if the sneezing is caused by something viral, the antibiotic can help by taking care of other nagging infections you may not even know about, leaving the immune system free to focus on the virus. I'm wondering if she's had something brewing for a while that is being helped by the antibiotics?

Please do get the ketone test in as soon as she obliges , any ketones in the picture will radically change any suggestions we make. But right now, that's a great BG!

 

Ketones, Diabetic Ketoacidosis (DKA), and Blood Ketone Meters

 

The antibiotics could be the culprit on the poor appetite (or the respiratory infection itself; cats don't like to eat things they can't smell). Or there could be something like pancreatitis going on, as I think Bron suggested.

Any of those things could, if the poor appetite continues, lead to ketones which will further impact appetite. We can't really sort out all the cause-effect over the internet, but those are some of the possibilities as to what is going on here. [Edited to add: we strongly emphasize ketone testing in these situation because ketones are extremely dangerous, and must be treated quickly and aggressively when they appear]

Fingers crossed it was just a little blip and that Candi is on the mend!

 

Okay! Yes she ate a little more pate. I will leave it out in case she needs to eat. That's very helpful. I will keep an eye on her appetite and test when I can. I'll try and catch her in potty. Thank you all!

 

Didnt post that link to scare you. Knowledge is power.

 

Hi Becca,

Typing...


Mogs
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It's just confusing. I thot it was a good thing but it might indicate ketones is scary. Do you think I need to set up a vet appointment for monday?

 

So glad she ate a little more! What a relief! Warming up the food a little can make it smell more which might encourage her to eat.

 

as far as I understand high numbers and no insulin are a recipe for ketones BUT the fact that she could have an active infection THAT also can help ketones to develop.
PLEASE Nan correct me if I'm wrong.

 

Okay. I gave her the antibiotic and I'll try and catch her in the litter box.

 

I know its not easy... I never had to worry about ketones thank God. The learning curve is steep but I believe you are up for the task.

BTW Candi is as cute as she can be. What a cutie pie!

 

Ketones can develop in a diabetic when there's not enough food + not enough insulin + a stressor (infection/inflammation). The high numbers aren't a direct cause, they just tend to be associated with the not enough insulin + stressor parts of the equation.

Similarly, lower BG numbers are not in any way a protectant against ketone development! That's why we get concerned when low numbers and low appetite lead to shots being skipped. And when there's an infection on board as well, all the alarms are flashing red.

When you get that ketone test, anything above "trace" warrants a trip to the ER vet-- waiting until Monday is not an option. If ketones are negative and her appetite continues poor, you will want to at least call your vet for advice and possibly take her in. She may just need a different antibiotic, or possibly an anti-nausea med to counteract the side effects (I think Clavamox is one of those that is notorious for causing nausea).

 

Hi again, Becca.

I'm sorry you're dealing with such a distressing and tricky situation.

Please note, the following suggestions are based on an understanding that Candi does not have a history of throwing ketones or episodes of DKA.

First up, an important general safety note:

Based on the PM reading of 97 (Alphatrak) I think the 1.5IU Vetsulin dose is a bit too high, even for a normal day, and therefore suggest that you reduce it going forward. Candi has hit BG below 90 on an Alphatrak on this dose. The FDMB Vetsulin guidelines indicate a dose reduction if BG falls below 90 on a human meter, so the threshold for dose reduction on an Alphatrak meter would be a higher value (low 100s as a rough estimate).

For today, if Candi does get high enough to give insulin (>200, possibly even >220 on an Alphatrak), I very much recommend you give a dose smaller than 1.5IU for the reasons given above.

* Wait two hours after food.

* Test.

* If BG high enough to give insulin, feed Candi again. (Over 200 minimum.)

* If BG almost high enough, stall without feeding, test again in 20 minutes and, if now high enough to give insulin, feed and go to next step.

* If, and only if, she eats enough - a very good meal, just in case she won't eat more later while the insulin's active in her system - wait 30 minutes and then administer the reduced dose of insulin.

Monitor BG throughout the cycle - especially in period from +1 to +4 when BG drop is likely to be fastest and strongest - until numbers rise significantly (usually after +7 or +8). If numbers fall significantly any time after dose onset then intervene with food (and honey if necessary) to keep numbers in the safe range. Post for help but bear in mind that the board is quieter at weekends. (I won't e around most of today either, I'm sorry to say. )

If Candi's appetite remains very iffy, you could consider giving a token dose. I would not be comfortable suggesting any more than 0.25IU and only on the proviso that you can monitor her closely throughout the cycle to keep her safe.

If in any doubt, especially if you can't monitor Candi throughout the cycle, it would probably be safer to skip, this time with the proviso that there is active monitoring for ketones today.

To catch a urine sample, spread some plastic food wrap over the surface of the litter in the box. Push down in the litter in her 'favourite spot' if she has one. It will allow the urine to pool a bit and make it easier for you to get a sample. Other tips for collecting urine samples here.

* If clear for ketones, test again tomorrow. (By then you'll hopefully have been able to get to talk with - and hopefully visit - your vet.)

* If trace ketones, test again later today and in the morning (assuming that subsequent tests are negative or trace).

* If any higher than trace, take Candi to a vet immediately for emergency treatment to flush out the ketones.

As others have posted above, if Candi's having problems smelling her food then she'll be disinclined to eat. If you haven't already done so, try warming her food a little to increase the aroma. Also try to see whether she might take a bite or two from your hand. Sometimes that can help reassure a kitty that the food's safe to eat even if sense of smell's a bit off.

It'd also be a good idea to check Candi's behaviour round food points to any nausea. Clavamox can really upset the GI tract and give rise to eating difficulties. (If Candi's stools have loosened since starting the course that would be a pointer to a GI disturbance.) Here's a helpful resource:

Nausea Symptoms Checklist and Treatments

A simple thing to try is raising up food and water bowls a couple of inches to make it more comfortable to eat if the tummy's a bit iffy. More suggestions here (including suggestions on cat-friendly baby foods (no onion, no garlic!) that can often tempt a cat to eat when it won't touch regular foods):

Persuading Your Cat to Eat

Hope some of the above helps. (Sorry it took me so long to type this.)


Mogs
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Maybe a bit of probiotics would help her belly feel better.

 

And how! My civvie, Lúnasa, had to have two month long courses back to back to treat UTIs (she has CKD, hence the longer courses). It was the devil's own job trying to get food into her. She'd have starved were it not for twice-daily ondansetron for the nausea. She also had diarrhoea for so long on the second course that I began to despair of her ever having a normal poop again! She was miserable while taking it too, poor creatúir. (((The Noodle)))


Mogs
.

 

Awwww..... poor little Noodle! I felt bad even 'liking' that report on her woes, that sounds absolutely miserable!

 

Thank you so much!

 

That sounds just pitiful!
Yeah I'm sure she has diarrhea and I'm certain she feels maybe at the least nauseous. Its never like her to act like this. I'll watch it and definitely get her in tomorrow to the vet! Thanks!

 

It was a relief to stop them, Nan. Her GI tract got so messed up on the second course that I asked the vet to check her for pancreatitis (she had an acute episode a few years ago after GI problems caused by her hyperT). Thankfully she was negative but the vet agreed to prescribe bupe for her. It helped her to eat better, thank God, and her poops seem to be normalising since cessation of the co-amoxyclav (anti-jinx!). The Noodle has regenerative anaemia thanks to the CKD so any inflammatory processes are a really big deal now. (((Noodle)))

ETA:

BTW, the first course was for a staph infection but when the post-course follow-up urinalysis C&S was done, the staph infection was gone, only to be superseded by an E. coli infection. Got a call from the vets on Saturday to say that the follow-up C&S after the second course was clear! Also her haematocrit is still OK. I am so relieved.


Mogs
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I hope Candi feels better soon. Sending solidarity scritches for her.

(((Candi)))


Mogs
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Thank you! She will be going to the vet tomorrow regardless.

 

Be sure to let us know how Candi gets on tomorrow, Becca.




Mogs
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Yes ma'am! Thank you guys for yall you guys help.

 

Hey just checked her ketones with a ketone test strip at +40 since last shot and it looks negative.

 

Does it look negative to u?

 

Congrats on the ketones test! Yes, that looks negative, as long as that picture was taken at the specified time (the strips will darken over time, so you have to look at them at the number of seconds they say in order to get an accurate reading).

 

And now she vomited. I'm really guessing the antibiotics are to blame. Shes never never been good with antibiotics in the 11 years I've had her. Diarrhea and vomiting has always been side effects except for the injectable antibiotic which I dont understand why they didnt give her. She already had one injection of antibiotics so I guess that's why?

 

It looks negative to me.

I cannot access your spreadsheet.
Can you go up to the top right hand corner and click "share"?

While you are there, you can change the link to your spreadsheet.

To change the link on your spreadsheet.
1. Copy the link. It starts off like this: docs.google.com/spreadsheets/blahblahblah This is your URL.
2. Go up to the top right hand corner and click on "Becca84"
3. Click "Signature"
4. Delete "CandiSS"
5. Type "CandiSS"
6. Make sure to highlight all of "CandiSS"
7. In the upper left hand corner of the typing box you will see a link symbol. It looks like this:

​

Click on the link.
8. A new box should open up which tells you to paste the URL
9. Paste the URL
10. Save changes.

I'm not a techie but I think this should work.

 

The uppercase "C" in CandiSS should let u in...I tried to shorten it but it never worked

 

When I click on the "C" I'm told I need to request access.

The difficulty with just the "C" highlighted is that it is not easy to notice because the type used in the signature is so small.

 

Will Candi eat out of your raised hand?
And what @Critter Mom mentioned earlier. Raising the bowls a couple of inches is a simple trick.

 

Me, too, and I was able to see the spreadsheet just fine earlier this morning .

 

Your telling me..have u tried my link in the orginal post?

 

Well she just vomited and is looking at the food as if she wants to eat but scared. I think I'm stopping the antibiotics to see if that will help and I have raised her bowl and shes still unsure. I'll run and get pepcid in a few minutes.

 

I just clicked the C and got the same as Kel.
It worked earlier. I know because I tested it.

 

https://docs.google.com/spreadsheet...xpr0xjz2tiX8UyJM3SQA2daxhA8/edit?usp=drivesdk

Try that until I can figure out how to fix it.

 

My cat gets the runs too. Probiotics could help. FortiFlora

 

I FIXED IT! link sharing wasn't on

 

That sounds very much like nausea-related behaviour (obviously hungry and interested in food but reluctant to eat).

Skipping a dose shouldn't be a big issue (I did on occasion with the Noodle, just to give her a break).

I don't know whether this might be an option in the time of covid but it's also possible to give co-amoxyclav by injection. Each injected dose lasts 3 days and it's not as hard on the GI tract. Maybe ask your vet about this tomorrow?

Word of warning: If your vet proposes giving Candi a long-lasting antibiotic injection, check whether it's Convenia (generic name is cefovecin). Convenia is often prescribed wrongly for all manner of infections, purely on the basis that it removes the need to pill the cat. However, it is only truly effective for skin infections. I'd suggest asking about an antibiotic better suited to Candi's current needs. (Note: There have been reports of possible adverse reactions to Convenia - see catinfo.org on this subject.)


Mogs
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The flora florta?

 

I agree. I think we might just stop them all together.

 

Can you make the hyperlink the whole word instead of just the C?

 

FortiFlora is a probiotic that often helps with diarrhea. Purina Pro Plan Veterinary Supplements FortiFlora With Probiotics Feline Nutritional Cat Supplement https://www.amazon.com/dp/B001650OE0/ref=cm_sw_r_cp_api_fabc_s.wSFbYV1NKZM?_encoding=UTF8&psc=1

 

To make your spreadsheet link more visible:

1. Copy the link to your spreadsheet to the clipboard.

2. Edit your FDMB signature.

3. Highlight the 'C' with the current link and then click on the Break Link icon:





3. Now highlight 'CandiSS' in your signature.

4. Click on the Link Icon and paste in the link from the clipboard.

You should then see 'CandiSS' appear in blue text (showing it's a web link). Save the changes and everyone should find it easier to see the spreadsheet link in future.


Mogs
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I've tried..it will only highlight the C...I'll try again after I go to the store.

 

See my post above for some tips (we cross-posted).


Mogs
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Yay! I did it!

 

Certainly did, Becca! Much easier to see now.


Mogs
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Whooohoo. Well done! you really are a rock star. Your cat is so lucky to have you.

 

This is my weekend to sleep, I usually wake up at 730am to feed her and go back to bed, but I've been so worried over this girl I've stayed up and now it's like 1:30p. Lol she means the world to me and I dont care if I lose sleep for her. I'm about to go buy some pepcid for her. Shes my special girl!

 

We use fortiflora If I dont sprinkle it on Zoes food she gets the runs. Have NO idea why or how that works but it does.
Its not the best probiotic. But the added benefit is that it entices them to eat.

 

I will hafta order that from chewy. It will take some time. But thank u

 

Its a bit pricey.

 

I saw!

 

Pricey? It's a complete rip-off!


Mogs
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The pepcid said now to chew but can I crush it?

 

Ive never had to use it but my friend just pilled her cat. I dont know if it made a difference.

 

I've skipped 3 doses. I've checked her bg @ +42.5 and shes 203.