Newly Diagnosed

Discussion in 'Feline Health - (Welcome & Main Forum)' started by schlania, Aug 14, 2020.

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  1. schlania

    schlania Member

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    Hello all, I am new here, I have a cat who was diagnosed with diabetes a week ago..They sent out blood work on Saturday and it came back on Tuesday, They called and said he was diabetic and we made the appointment for today, to start insulin..The problem is he is not eating, today he was dehydrated, so they subcutaneous fluids, gave a antibiotic and b12 shot, also appetite stimulant.. I have already mad a appointment with another vet, They tell me it is probably something else wrong?I have been feeding fancy feast pate, but he will take like 4 bites then walk away.. Any advice would be appreciated..
    Thank YOu
     
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  2. schlania

    schlania Member

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    They cannot start insulin because he is not eating? I dont know what to do for him..
     
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  3. Panic

    Panic Well-Known Member

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    He sounds like he may be nauseous. Did they give an anti-nausea such as cerenia or ondansetron? An appetite stimulant isn't helpful without it. He may have something like pancreatitis. I would take him to the vet ASAP and get a SNAP fPL done.
     
  4. schlania

    schlania Member

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    No antinausea meds, just the stimulant
     
  5. Lisa and Witn (GA)

    Lisa and Witn (GA) Well-Known Member

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    Did the vet check for ketones to make sure he is not dealing with diabetic ketoacidosis? This is a very serious condition and needs medical treatment ASAP.
     
  6. schlania

    schlania Member

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    They just said they think it is something else
     
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  7. Panic

    Panic Well-Known Member

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    Please get him to the ER to check for ketones. These issues can't wait.
     
  8. schlania

    schlania Member

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    They tested for ketones on sat and it was negative
     
  9. Panic

    Panic Well-Known Member

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    They need checked today, ketones form within 24 hours.
     
  10. schlania

    schlania Member

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  11. Panic

    Panic Well-Known Member

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    Thank you, please let us know what they say!!
     
  12. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Glad you are going to the ER, please keep us posted :bighug:
     
  13. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    sending prayers and healing vines.:(
     
  14. schlania

    schlania Member

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    Well no ketones and pancreas was good and his glucose was 250 compared to 398 on saturday, but the vet did say he has fatty liver and he has a little jaundice, so they gave him cerenia and famotidine and now my biggest hurdle is to get him to eat..I will syringe feed him and hope his appetite picks, otherwise they said hospitaliztion with iv or a stomach tube..
     
  15. Patty & Teal'c

    Patty & Teal'c Member

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    Oh just looked at your avatar what a cutie he is.
     
  16. Panic

    Panic Well-Known Member

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    Feeding tubes are a blessing when needed. Glad no ketones or pancreatitis, but let me ping some mods who hopefully have knowledge for fatty liver. We want your kitty to have the best chance of recovery!

    @Sienne and Gabby (GA)
    @Marje and Gracie
    @Wendy&Neko
     
  17. schlania

    schlania Member

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    Thanks to everyone i just want him better and to hopefully get this under control for him
     
  18. Panic

    Panic Well-Known Member

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    @tiffmaxee
    @Critter Mom

    What did the vet say about giving insulin? I'm trying to find some older forum threads about fatty liver and reading that an appetite stimulant might make things worse. Hoping someone with experience will be online this evening.

    What is your boy's name?
     
  19. schlania

    schlania Member

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    His name is Blitzey. My vet and the er vet both said they dont want to insulin until he is eating regularly, i have a appt with another vet this week who was recommended by a friend
     
  20. Panic

    Panic Well-Known Member

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    Oh Blitzey! I have a girl named Blitz!

    Red was kind enough to send me this. Sounds like he shouldn't be on an appetite stimulant right now.

     
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  21. Lalkabee

    Lalkabee Member

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  22. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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  23. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    With hepatic lipidosis (aka "fatty liver') the challenge is to get your cat to eat. I'm hoping the ER vet gave you an appetite stimulant (either mirtazepine or cyproheptatine although there are some less frequency used medications, as well). And anti-nausea medication may also help (typically Cerenia or Zofran/ondansatron). Please be aware that the anti-nausea meds are bitter and can cause a cat to foam or drool. Using a blank cat-sized capsule can help with both pilling and avoiding the bitter taste. Capsuline is a company that has pet-sized capsules.

    This is a post on some options that can help to entice your cat to eat. There is also a concoction that has been used here for virtually forever to help sick or inappetent cats -- the infamous liver shake. It may be worth giving it a try.

    If you are going to syringe feed/assist feed your cat, do not use your kitty's favorite food. There have been instances when using a particular food to assist feed results in an aversion to that food. You might also want to consider using a food that's high in calories since you'll get a bigger bang for your buck. You may want to talk to one of the vets to see if they stock CliniCare which is a high protein, liquid product. Hill's A/D is also a canned food that can also be used. A food that's high is protein is ideal.

    Do not overfeed your cat. You want to give small, relatively frequent feedings. If you try to give too much at once, your kitty will vomit and the entire purpose is defeated. In round numbers, your cat needs about 20 calories per pound of ideal body weight. You will want to break this up throughout the day. You also may need to start out feeding your cat less than the normal amount of calories. For example, the first day, 1/3 to 1/2 of normal then the second day, 2/3 of normal and then hopefully, your cat's stomach will have readjusted to eating.

    There are also supplements that can provide liver support. Ursodiol and SAMe can both provide support for a healing liver. A B12 (cobalamin) shot or oral supplementation can also help with absorption of nutrients from the gut.
     
  24. Ale & Bobo & Minnie (GA)

    Ale & Bobo & Minnie (GA) Well-Known Member

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    I hope it doesn’t come to that, but if Blitzey needs a feeding tube I can help you with the logistics. It can be a blessing like Panic said for food and meds and it’s not as intimidating as it sounds. I hope he feels better soon! :bighug::bighug::bighug:
     
  25. Dusty & Roe

    Dusty & Roe Member

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    How is Blitzey doing today ?
     
  26. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Thanks Ale ! I was AMAZED at how you handled that like a pro. Minnie is one lucky little kitty cat!

    And look at little Blitzey hes a little cutie patootie!
     
  27. Ale & Bobo & Minnie (GA)

    Ale & Bobo & Minnie (GA) Well-Known Member

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    Sometimes you’ve got to dust off those big girl pants and put them on!! :nailbiting::nailbiting::nailbiting:

    he’s sure a cutie pie!!!
     
    Last edited: Aug 15, 2020
  28. Panic

    Panic Well-Known Member

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    So Blitzey DOES need to use appetite stimulants? Just want to make sure since the information above said they were inappropriate. Don't want to be spreading misinformation. :nailbiting:
     
  29. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    @Panic
    I don't think it can hurt. (Did I say that? Or did someone else say it was inappropriate? If it was me, it may have been an autocorrect from inappetent.) I'm pretty sure that Gabby was prescribed an antibiotic, Cerenia, and an appetite stimulant. I did a quick search and mirtazepine is commonly used with HL.
     
  30. Panic

    Panic Well-Known Member

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    @Sienne and Gabby (GA) No, I saw it mentioned in some older threads last night when I was trying to read up on it and the article Red found for me that I copied and pasted above said this (link is above, from Merck):

    Because cats with HL are in metabolic liver failure, appetite stimulants are inappropriate; diazepam, oxazepam, cyproheptidine, and mirtazepine should not be used and will not recover an affected cat. Occasionally, an appetite stimulant may help initiate feeding early in syndrome development.

    Just wanting to be sure!
     
  31. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    @Panic
    I honestly don't know the answer. The Merck Manual is typically up to date. What I couldn't tell is whether there's a clinical differentiation between a cat that has had liver damage/disease from HL vs a cat that is in early stage. When Gabby was diagnosed, her symptoms were reversing by the time she was discharged from the ICU. They had sent labs to TAMU since that was the only lab (at least at the time) that was running the appropriate GI related tests. She was not jaundiced but I think some of her liver values were off. What it looks like the more recent research suggests is that at least with mirtazepine, it's half like in a cat with HL is far longer than in a normal cat. If it's used, it needs to be dosed less frequently so toxicity doesn't occur.
     
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  32. schlania

    schlania Member

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    As of today they want to hospitalized him. I am away on orders and this is killing me not being there the suspect from bloodwork pancreatitis, hepatic lipidoses and diabetes. I can't treat the diabetes because he is not eating enough. The total bill for hospitalization would be around 5000, which I do not have. I have been syringe feeding and he actually has eaten a half can of fancy feast by him self. I do not want him to suffer, he has had sub q fluids every other day because he gets dehydrated. He has been to the vet every day. I don't know what to do for him?
     
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  33. schlania

    schlania Member

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    They want to hospitalize him at the tune of 5000, which i do not have. They have suggested a feeding but say he must be hospitalized. I am lost at this point and cannot be there with him as I am on miltary for 2 weeks. He has been to get fluids 3 times since friday.
     
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  34. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Do you have care credit? sigh... I'm trying to remember who has experience with this
    @Aleluia Grugru & Minnie
     
  35. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    I do think hospitalization is needed I am very sorry. :(
     
  36. schlania

    schlania Member

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    Already exhausted my limit, and they won't increase
     
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  37. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Last edited: Aug 18, 2020
  38. schlania

    schlania Member

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    They just said he also has a heart murmur
     
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  39. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Yeah he needs to be hospitalized sigh I HOPE I'm wrong hold on.
     
  40. schlania

    schlania Member

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    The vet is recommended euthanasia,
     
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  41. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Yeah I'm sure they did. :(
     
  42. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    I'm just trying to find someone to confirm or help. sigh
     
  43. schlania

    schlania Member

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    They gave him fluids and meds. So my husband can try the fluids for the next few days and see how he does with the meds. I will go home sat and evaluate i just dont want to do more harm than good for him. Should I see if I can find a vet to da a feeding tube or should I let him go they said it is 50/50 even with hospitalization
     
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  44. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Feeding tubes arent as scary as they sound Ale has had experience with them also GOOD experience. Its seems everyone is taking a break at the moment. But dont give up just yet ok?
    Sigh I wish I could give you definitive answers.
     
  45. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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  46. tiffmaxee

    tiffmaxee Well-Known Member

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    Hepatic lipidosis is an emergency. He needs to go to the vet or ER. Let us know what they say. It happens from not eating enough and a feeding tube might be needed.
     
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  47. Panic

    Panic Well-Known Member

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    I'm sorry, I don't know the answer either. It sounds like he has a lot going against him.

    These tags simply aren't going through - perhaps you could make a new thread with URGENT in the title so others can see or use 911 tag so others can see it and help you with Blitzey.
     
  48. tiffmaxee

    tiffmaxee Well-Known Member

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    Heart murmurs can be benign or not. They would need an echo to determine.
     
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  49. schlania

    schlania Member

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    It is 5000 to stay at er. I dontt have that much, he also has pancreatitis and a heart murmur. They said even with hospitalization he has only 50 %chance
     
  50. tiffmaxee

    tiffmaxee Well-Known Member

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    He needs IV fluids I would think.
     
  51. tiffmaxee

    tiffmaxee Well-Known Member

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    Is this this an ER you have been to before? They always quote the high end. Can you get the vet to talk to your regular vet or don’t you trust him?
     
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  52. tiffmaxee

    tiffmaxee Well-Known Member

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    Cats can get hepatic lipidosis from eating less than 1/2 their normal amount in just a few days. It’s serious and they are probably right about 50/50. I’m so sorry.
     
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  53. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Oh I wasnt aware. ty
     
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  54. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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  55. schlania

    schlania Member

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    I have been to 3 different vets the first vet blew me off, so i went to a emergency vet ans said he had ftty liver, to syringe feed for 3 days and if he didnt start eating on his own he would need a feeding tube , so my husn=band took him to a emergency vet today and the quoted 5000, gave him pain meds, anti nasea meds and fluids i cannot seem to get a vet to a feeding tube..
     
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  56. schlania

    schlania Member

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    he does eat on his own but only one can of fancy feast today
     
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  57. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Hmmm
    @Aleluia Grugru & Minnie
    did you have trouble getting a vet to use a feeding tube?
     
  58. tiffmaxee

    tiffmaxee Well-Known Member

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    You need to syringe feed him more than that. How much does he weigh?
     
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  59. tiffmaxee

    tiffmaxee Well-Known Member

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    What was he given for nausea and dose? Has he lost a lot of weight?
     
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  60. tiffmaxee

    tiffmaxee Well-Known Member

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    Any veterinary surgeon should be able to do a feeding tube. Ale has a good clinic she uses that does everything.
     
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  61. schlania

    schlania Member

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    He weighs 10.3 lbs, I am having trouble finding a vet that will do a feeding without hospitalization
     
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  62. Ale & Bobo & Minnie (GA)

    Ale & Bobo & Minnie (GA) Well-Known Member

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    Are you in Los Angeles? Yes Minnie had a feeding tube tube put in. It’s an operation so they have to go under anesthesia for the tube to be inserted. $5,000 seems high to me but it will be a couple thousand for sure. I used MASH, Metropolitan Animal Hospital. It was done by internal medicine. I don’t know if a regular vet can do the tube.
     
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  63. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    are you in California?
     
  64. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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  65. Panic

    Panic Well-Known Member

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    Her profile says Florida :/
     
  66. schlania

    schlania Member

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    I am in florida, the wrst part is I am 500 miles away on miltary orders , that was the quote from the emergency vet for a week of hospitalization, feeding tube, and a bunch of test
     
  67. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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  68. schlania

    schlania Member

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    He's is on cerenia, he has lost about 5 lbs in about a month
     
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  69. Panic

    Panic Well-Known Member

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  70. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    arrrg I couldnt find that link for the life of me. Please click that link!
     
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  71. schlania

    schlania Member

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    Florida
    Heats a can on his own and they are giving 2- 10 ml syringes 4 times a day
     
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  72. schlania

    schlania Member

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    Thank you
     
  73. tiffmaxee

    tiffmaxee Well-Known Member

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    That’s too much weight loss and why he’s got hepatic lipidosis. I’m so sorry you are far away. Maybe the clinic will cut yiu a break for being in the service? The thing is there’s no way to know long long he will need to stay at the ER. They quote worst case but it’s possible.
     
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  74. schlania

    schlania Member

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    No break, and the low end was 4300, so they gave him fluids and can do fluids at home and got a referral from a friend about a really good holistic vet who is also a surgeon and would do a feeding tube if she deems necessary so I am going to try to get a appointment with her tomorrow.
     
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  75. tiffmaxee

    tiffmaxee Well-Known Member

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    I’m so sorry you are in this situation. You need to get food into him to beat hL. Feed a couple syringes ever couple of hours. Ask for an appetite stimulant too the transdermal Mirtazapine.
     
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  76. schlania

    schlania Member

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    He is on a stimulant and my mom and husband are giving him 2 10 ml syringes 4 times a day and he eats a can of fancy feast on his own thru out the day
     
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  77. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    I hope thats enough. sigh Just keep trying things. Some cat go nuts for rotisserie chicken...baby food (without onions and garlic)...
    Anything you can think of.
     
  78. tiffmaxee

    tiffmaxee Well-Known Member

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    Tell them to try and feed him as much as they can. Did you say how much he weighs? Eating on his own is good.
     
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  79. schlania

    schlania Member

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    He weighs 10.3 lbs, he eats 1 can of fancy feast on his own thru out the day, and they syringe feed
     
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  80. tiffmaxee

    tiffmaxee Well-Known Member

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    What should he weigh? Was he overweight before he lost 5 pounds?
     
  81. schlania

    schlania Member

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    He had gained about 5 lbs over the last year but had always weighed about 11 lbs
     
  82. tiffmaxee

    tiffmaxee Well-Known Member

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    Ok. So he was overweight and lost weight way too fast. Overweight cats need to lose very slowly or they get fatty liver which is what he has. Try and get him to eat 2-3 cans of fancy feast.
     
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  83. tiffmaxee

    tiffmaxee Well-Known Member

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    You might see if he will eat all meat baby food. Gerbers 2nds makes chicken, turkey, beef,and ham. Max would eat it usually even when he wouldn’t eat cat food. It doesn’t contain onion or garlic so read the label if you try another brand. And maybe cooked plan chicken?
     
  84. schlania

    schlania Member

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    Tomorrow the vet is going to a ultrasound of the pancreas and liver and if that looks good she will insert a feeding tube, and we can start insulin. he has eaten 2 cans of fancy feast on his own, so maybe he is going to start eating on his own...
     
  85. tiffmaxee

    tiffmaxee Well-Known Member

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    Paws and fingers crossed. :bighug::bighug::bighug::bighug:
     
  86. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Oh my gosh How did I manage to miss this news ? How wonderful! I still dont know kitties name...
    but If I did I would shout GO KITTY GOOOO!!!
     
  87. schlania

    schlania Member

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    His name is blitzy. And I really hope this good news
     
  88. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Duhhh jeanne yes I remember now. Sorry its SO hot in this house I'm kinds in heat overload.

    It is good news eating on his own is huge. Sending hungry vibes Come on Blitzy EAT!
     
  89. schlania

    schlania Member

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    Update on blitzey, the ultrasound revealed he has a fatty liver, pancreatitis, thickening of the large intestine and his spleen is slightly enlarged, she did a biopsy to check for lymphoma, which could cause the thickening of his intestines and the enlarged spline, or if the test is negative she said it would be ibs, she hydrated him and started insulin since he is eating on his own and his glucose is at 450, just have o closely monitor him, if the biopsy is negative she will proceed with a feeding tube. poor gut, he was fine and then within a few weeks just went down hill and it is worse that i cant be there with him...
     
  90. Panic

    Panic Well-Known Member

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    Poor Blitzey, that's a lot happening at once! When do you get results from the biopsy? So glad he's hanging in there!
     
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  91. schlania

    schlania Member

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    She said 2 to 3 days hopefully sooner
     
  92. tiffmaxee

    tiffmaxee Well-Known Member

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    No masses so that’s good. She seems to be a good vet unlike that rotten ER. If small cell lymphoma it can be treated easily. I have sources I can send you for info. If IBD you will need one pill and possibly a diet change. Let us know what you find out and treatment plan and I’ll send more info. :bighug:
     
  93. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    HES EATING ON HIS OWN??? whew!
     
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  94. schlania

    schlania Member

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    He eats about 2 cans not at once but throughout the day, so she said she would rather him eat two big meals but we will take this for now
     
  95. tiffmaxee

    tiffmaxee Well-Known Member

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    I totally disagree with two meals. My internal med vet reminded me every time Max had a pancreatitis episode to feed small meals more often because if they eat too much at one time they don’t feel well and then associate that with the food. It worked for Max. It also helps regulate BG.
     
  96. schlania

    schlania Member

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    I had read that also, I think i will let him eat a few times versus 2 big .eats, but how does that effect the insulin?
     
  97. tiffmaxee

    tiffmaxee Well-Known Member

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    It actually helps. I fed the meals up to about 6 hours after insulin unless he needed food because his bg was low. Many here actually free feed but pick up the food 2 hours before insulin so the pretext isn’t food influenced and artificially high. Once they have enough data some always free feed. Your cat is eating the small meals on his own which is good for him.
     
  98. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    I see Blitzey has been treated with Cerenia. I'd also recommend also asking your vet about ondansetron if his nausea returns.

    Cerenia and ondansetron work in different ways to control nausea, and they can be used together if required.

    ETA: Also suggest asking your vet whether a course of B12 injections might help (good for pancreatitis and can help improve appetite).


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    Last edited: Aug 20, 2020
  99. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    @tiffmaxee -

    Elise, do you know whether or not bupe is contraindicated when a cat has hepatic lipidosis? (Just wondering whether or not it could be given to help with the pancreatitis.)


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    jt and trouble (GA) likes this.
  100. schlania

    schlania Member

    Joined:
    Aug 11, 2020
    I will ask about that.. also she said 1 unit of vetsulin 2x a day, morning and night. Is this too much? And he got a shot at about 230 should he get another one tonight? They didn't suggest a tester but we got anyway, so his blood should be tested first?
     
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