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Cat hospitalized, need some information please!

allycat0303

Ideal_Rock
Joined
Nov 19, 2004
Messages
3,258
Hi everyone,

I'm a little frantic right now and don't know what to do. The family cat (he live with my parents but I grew up with him) is very ill. Zebra is 14 years old, he was diagnosed about 8 weeks ago with diabetes. My parents discovered the problem when he had a tooth infection, and became lethargic. With all of the tests, we discovered he was diabetic.

For 2 months he has been well. Then on Thursaday, my father noted that in AM he only ate 1/4 of his can of food in the morning. Usually he eats it all. At supper, he didn't eat anything. The next morning on Friday, again, he only ate 1/4 and was lethargic, he wasn't coming to us when we called. Friday at noon, I came over, and took a blood suger (my parents aren't able to do it, and I came as soon as they told me he was unwell). He was still moving around, although not that active, stayed curled up when I came over, instead of running up to me.

His blood sugar was 30, so I took him to the vet....

Well at the vet, it was kind of a strange experience. The vet said he was dehydrated (which I agreed with). He didn't really make any suggestions. Finally at my pushing, he said I should take him home and give him fluid subcutaneously. I said "ok.." So the technician showed me how to do it, by giving 15 cc of volume. Seeing how it was done, Zebra meowed like it was really painful, so I went to the vet, and told him I would prefer if he was kept overnight to give him fluid IV. I didn't feel comfortable giving him 5-6 painful injections. My rationale was that I thought an IV would be less painful, AND they would be able to give him more fluid.

So this morning (about 12 hours after we had left him at the vet) I went to visit him. He was getting IV, and his skin turgor was better. HOWEVER what really worried me that he was REALLY lethargic. Like barely lifting his head. I was so upset that I just left (not smart, but the vet wasn't in, and I didn't think of talking to a technician.).

So I'm turning to you guys for help. After thinking about this, I'm wondering, is it possible that vets give a cat a bit of sedation while the IV is in????? I'm wondering if this could account for the lethargy. I'm terrified it's because he's getting sicker! At the same time, wouldn't a vet/technician call us if our pet was getting sicker and sicker??? Realistically, I figure an animal is like a human diabetic. Most humans don't die of hyperosmolar state. They need aggressive hydration and insulin.

And the vet didn't even want to keep him overnight initially. Even AFTER I asked them to give it to him IV, he told me, "Why don't you take him home and try it subcutaneously, and if it doesn't work, bring him in tomorrow AM." This leads me to think he didn't think the cat was THAT dehydrated.

Anyone have any insight? I'm completely unaware of how vet's work. This is the first time any of our pets have been this sick. I'm just concerned because he looked even more lethargic then when I left him last night.
 

Amys Bling

Super_Ideal_Rock
Joined
Jun 25, 2010
Messages
11,025
Can they run other tests?? This happened to our pug a few years ago on christmas day... not eating, dehydrated, really legthargic.... turns out after IVs and such he was no diabetic but had more serious issues, I say ask to have other tests or ultrasounds done.
 

bee*

Super_Ideal_Rock
Joined
May 14, 2006
Messages
12,170
Hi ally, I'm a final year vet student and have worked in a clinic for the past 7 years and from the sounds of it, they're treating you and your cat terribly. Firstly, if your cat was very dehydrated they should have taken him in on IV fluids without you having to ask-subcut fluids are very painful for them, especially as you have to give large amounts to a cat. They usually don't sedate if they're putting them on IV fluids, and usually you try and not sedate a dehydrated, diabetic cat anyway. Has he been on insulin for the past 8 weeks? Have they ran a general blood test yet to test for the other organs?
 

movie zombie

Super_Ideal_Rock
Joined
Jan 20, 2005
Messages
11,879
insulin may need to be adjusted.
may have a thyroid issue on top of it.
i'd take the cat to another vet.
i realize you are upset but spend as much time with your cat as they will allow you at the vets. your cat will appeciate your presence.
you won't know if they're giving sedation unless you ask. again, i realize you are upset but you are in charge here and can and need to be asking questions instead of spiraling emotionally. believe me, i do understand....i've been down this road more times than i care to share.
for your cat's sake please start asking questions until you are satisfied with the answers.....even if it is with another vet.
 

allycat0303

Ideal_Rock
Joined
Nov 19, 2004
Messages
3,258
Hi Bee,

I remembered before I wrote the post that you were in vet school and only hoped you could answer.

He had a full set of labs + work up U/S and x-ray + urine 8 weeks ago. He had labs done yesturday only, because the vet said it was unlikely that he would develop organ failure this quickly. Which I have to say I agree with...in a human, I would not have repeated everything.

Labs are pending. As for subcutaneous fluids...well I don't know. It was hs suggestion...my sister is family doctor specializing geriatrics and she gives patients which are DYING subcutaneous fluids, because some patients complain that the IV is too painful. So that's why it sounded reasonable to me (and to my sister). When we actually saw how he reacted to the process, we decided against it.

When I first saw him, he just looked awful. The receptionist went in first, then said we could come in. He was curled up in a ball sleeping. I said, "He's not moving" And then she said "He was just moving." Then I pet him a bit, and he woke up. He just lifted his head, his eyes were glazed, and he leaned against my hand. He did not get up, he did not do anything else. When I pulled my hand away, he put his head back down and closed his eyes. Honestly, I thought he was dying. But as I was leaving, I discussed it with my sister, and we thought "maybe sedation" just because we couldn't imagine him NOT ripping out the IV. It was bandaged up his paw, but still! I don't know, I'm rationalizing it like he's a human...he shouldn't be dying because of decompensated diabetes, it's rare that it happens. Usually we give fluids, adjust insulin, find the cause, treat the cause, and that's it. I also feel like someone would get into contact with us, if they thought he was dying!! I'm really kicking myself right now. If I had asked the questions, I wouldn't be here freaking out now, and preparing to spend a sleepless night worrying!!

I do trust the vet (somewhat) all of my cats have been operated and vaccinated there (since I was 5 years old, and I have MANY cats in my life). He's very well establised and has been there for many, many years. However, having a cat neutered is not the same thing as hospitalization for a medical condition.

Zombie, Amy I'm just kicking myself right now. I just felt horrible, and didn't want to disturb anyone. It's very unlike me to NOT be aware of what's going on. I feel helpless. I should have asked to speak to someone, but I was so upset! Tomorrow morning, I'm going to go back, but I guess I was looking for some quick reassurance. We did check his thyroid and kidney 8 weeks ago and they were fine!
 

bee*

Super_Ideal_Rock
Joined
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Messages
12,170
Well hold out until the lab results return but if they were done 8 weeks ago, they will hopefully come back clear again. The main ones that you want to watch out for are renal and pancreatic parameters. We actually have a patient (and he was in with us today again) that has episodes which sound remarkably similar to what your cat is undergoing at the moment and he does go through episodes with his diabetes where we have to drastically alter his dose of insulin. He used to be on 2.5iu BID and is now on 6iu BID at the moment but it's been up and down every few months and every test has been unremarkable. We just have to take him in every couple of months and do a BG curve and usually that settles him down for another few months. He does present to us every so often completely flat and lethargic and with no appetite and he has to go on fluids for 3-4 days and he usually perks up again and his appetite comes back but it's very scary for his owners and obviously not nice to see. He's been referred to a specialist and they couldn't recommend any other treatment course other than the way that we're going.
If it helps when you're visiting tomorrow, write out what you'd like to ask as I know that a lot of our clients forget what they were going to ask when they come down and see their animal not feeling great. Check about sedation although it would be rare for them to do it in a lethargic cat. The majority of cats are quite good about keeping their IV lines in so that wouldn't necessarily point to sedation. On another note, hope all is going well with you-are you still doing your cardiac residency?
 

movie zombie

Super_Ideal_Rock
Joined
Jan 20, 2005
Messages
11,879
ok, you're deep breathing and going to take control. do not wait until tomorrow. call right now or go in right now. do not leave until you get answers. i will go on record as saying that in your situation i'd be camped at the vet's until i understood things....believe me, i've done this. i find its better not to be rude [difficult for me under these circumstances] and to let them know i appreciate what they are doing but that I NEED TO UNDERSTAND. please do not wait, for your sake or kitty's.

i give fluids to two cats here at home every night. it is important to make sure that the temperature of the water is right...not too hot, not too cold. easiest place is just below the back of the neck. i bunch up the loose skin there and make a fold before sticking a needle in....to make sure i don't hit muscle.

unfortunately, i've "lost" 5 cats now in the last 5 years or so.....and learned a lot each time about what i'd do differently the next time. the 4 remaining cats have a much better guaradian and advocate for their health than the first ones. i am very hands on and our vet has grown used to my questions and understands i do not settle until i am satisfied i understand what is happening. i hope you can resolve this health crisis with your kitty and establish a communicative relationship with this vet. however, you are right: i found that many vets are good at neuter and general health issues; but when it comes to the more complicated things, i made the decision to move on and never looked back. we pay an arm and a leg in vet bills for our cats because i insist on using the "specialist" and not just the "general" medicine type vets.

know that i really do feel for you and your kitty.
 

bee*

Super_Ideal_Rock
Joined
May 14, 2006
Messages
12,170
I keep forgetting it's a lot earlier in the day where you are-I would definitely get in contact and call down today and check what they're doing with your cat.
 

Miss Sparkly

Brilliant_Rock
Joined
Jan 2, 2010
Messages
1,664
So sorry to hear about your kitty :( Zebra is 14 which is old for a kitty, maybe it is just his time. Also, just because he was just diagnosed with diabetes doesn't mean it hasn't been working havoc on his system for longer. Hopefully it all works out for you and Zebra.
 

centralsquare

Ideal_Rock
Joined
Jan 18, 2009
Messages
2,201
I don't know much about cats, but just wanted to say that I'm keeping my fingers crossed that the little guy gets properly diagnosed and treated quickly. Poor thing!!
 

allycat0303

Ideal_Rock
Joined
Nov 19, 2004
Messages
3,258
bee* I got a few hours of sleep and just awoke in the middle of the night (2:00 am) and have been thinking about this. My family has decided to wait for the lab results tomorrow. If there are no abnormalities on the labs, they want to bring him home. Providing he is well hydrated. My family is adament against him dying at the vet. I will speak to the vet and see if he thinks Zebra is critically ill. Yesturday at the vet, the vet did not seem to think he was very ill, as he wanted to send him home....so I'm assuming he's under the weather, but not dying. His temperature was normal, physical exam was normal, vitals were normal.

There's many things which I am worrying about at this moment. The first being, I'm not convinced Zebra has been eating. I *assume* that while hospitalized, the vet will ensure/monitor his diet. When I came there, he had food in a bowl, but seeing how weak he was, I'm assuming he hasn't eating. I generally trust people. I believe that vets are equivalent to human doctors, they take care of their patients, people, so I trust the vet to be monitoring these things. If he wasn't eating, I'm sure they would have notified me/intervened.

So if he does come home, I'm going to have to give him some TLC for him to get back on his feet. Seeing him yesturday, I doubt he'll be 100% today (unless there is a miracle). So I've done some research. I might try to syringe feed him for a few weeks if he refuses to eat. I don't think I would go furthur and do entereal/parenteral feeding. I don't think that woud be reasonable considering his age, and his illness. For the moment, I'm going to go with LOTS of supportive care. Syringe feeding, maybe some hydration if he needs it, and we'll see. I'm a bit nervous about taking this on, but I'm going to do my best.

As for residency, well I'm an R3 now, out of 6. The second year was really hard, mostly, because the Chief Resident was quite cruel to me, and I had to endure a lot of abuse. He was frequently inappropriate (ie trashing me in the OR...when I was NOT around). My confidence is often fragile because of the debacle of getting in, it was quite difficult. That Chief resident left in May, and after that the new Senior and Chief residents are normal, decent human beings, so since then it's been easier. At the end of the year, in July, when I met with the program director, he told me that I was one of the most technically skilled junior residents to come through the service in the last 10 years. He told me he hoped that this would continue as a a senior resident. He did say that my biggest problem is a lack of confidence...which can sometimes be quite prominent. He also commented that in terms of patient communication, I was the best resident he had ever had as program director, barring none. So some positives, a big negative! Overall, I'm ok at what I do, and need some work. Although the Chief resident nearly got the best of me, I survived the second year which is the worst. Next year I will be the senior resident (so no one will be abusing me), and then the Chief resident (where only the staff will be allowed to yell at me). Thanks for asking! I'm sure you're thrilled to almost be finished and looking forward to working. Will you be setting up your own practice? Or continuing for more specialization?

MovieZombie: I'm sorry for your loss. I can see that you truly love your babies! You are a great advocate for your pets, and they are lucky to have you.

Sparkly Blonde: You are right of course, he is old! What you wrote was actually quite reassuring. Regardless he's lived a long life, and aside from the last 2 months, had been in reletively good health.

CentralSquare Thanks for your thoughts!

The vet opens at 10:00 today, so in about 7-8 hours, I'll be getting some news! Thanks for all the support you've given me.
 

bee*

Super_Ideal_Rock
Joined
May 14, 2006
Messages
12,170
Glad you got a few hours sleep. See what the lab results are and then decide. The most important thing if the results are clear is to make sure that he is receiving the correct amount of insulin and obviously that he is eating. Syringe feeding can be good but some cats really don't tolerate it well so you know your cat's personality best. I'm keeping everything crossed that he'll be a lot brighter tomorrow for you. I do think vets (and doctors) are people and you get good and bad so although it's great to trust them, do make sure that they are doing everything they can.
Yep I can't believe I'm almost there-cannot wait! I'm like you in that it took a while to get in so it feels great to be nearly done. I work in a 3 practice clinic so I've been offered a position when I qualify so I'll definitely work there for a bit. Not sure if I'd stay there and try and become partner at some stage or if I'd set up my own place, still haven't decided yet. I can't believe you're in R3-the years are flying by. Glad to hear that the horrible chief is gone-he sounds awful! I hate working under people like that. You'll be a great surgeon!
 

movie zombie

Super_Ideal_Rock
Joined
Jan 20, 2005
Messages
11,879
if your cat has gone w/o eating another problem that could have developed is

http://www.sniksnak.com/cathealth/liver2.html

this condition can come on during the time of his not eating and would not have shown up in tests conducted 8 weeks ago.

i took my cat to work and fed him via tube every 2 hours. this per the vet's orders.

i am advocate of cat dying at home.....if you have the means to make the passing easier. an unassisted home death can be something that many would rather avoid.

when a cat quits eating and acting the way you describe, there is something seriously wrong. i've found that the important thing is to get the cat eating and i will even feed cheap food with the idea i can get them back onto a healthy diet later.

do not assume the staff will call you. unless you make it clear to them that you want to be informed of any changes in your cat's condition and treatment, they may not. i know this from experience. you as the client have a right to be explicit. you have the right to call and ask for updates on his condition, even during the night.
 

tyty333

Super_Ideal_Rock
Premium
Joined
Dec 17, 2008
Messages
22,498
Sending you some kitty ***dust***. Hope they can figure out what is going on and he starts feeling better real
soon.
 

allycat0303

Ideal_Rock
Joined
Nov 19, 2004
Messages
3,258
OMG it was so crazy this morning!

So I called at 11:00 which was when the vet opened, and the receptionist said, '' you can only call after 12 for hospitalizations''. So we called back, and said, we want to know if we can take him home, and what is going on. The receptionist said, '' Call back in 1 hour.''
Then 5 minutes later they called us back and said that ''Zebra has detriorated, he`s not eating, his glucose is NOT controlled, he's doing horribly. We need to run more tests''

I nearly had a heart attack! How could he be doing WORST then yesturday...he was already lethargic and ready to die. I broke speed limits getting there! So I go in the back, and she looks at his chart, and then brings me in the back. And Zebra is standing up in his cage MEOWING! It was like a differnt cat. He started clawing at the cage! Then she looks at his file and says, ''oh his sugar is well controlled now, and he has eaten everything in his bowl. He`s having some loose stool though.'' Ok, talk about WRONG information. His skin turgor was way better, he was awake and walking around. They adjusted his insuline dose. And he's had loose stools intermittantly for years, especially when he is stressed. And he's had an IV for the past 2 days. My patients always have loose stools when they are on IV. I`m waiting to see the vet, but I'm going to take him home. I think I can do a much better job monitoring his glucose, adjusting his insuline, and making sure he's eating (syringe feed if necessary....but he ate all of the food in his bowl, so it won't be necessary.)

I got some lactate ringers, and an iv, in case he gets dehydrated, so I can give him subcutaneous or iv if he needs it. To me, he'll be better with his family. And I can give him the same treatments they would have with more TLC. I doubt they would take the time to syringe feed him if he wasn`t eating.

I'm so relieved! I was sitting in the waiting room in tears because I imagined him dying while I was waiting. I'm not sure why they said acute deteroriation...maybe they were talking about another cat.

He's going to be fragile for the next few weeks, but I'm going to do my best! Thanks everyone!
 

yssie

Super_Ideal_Rock
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OMG. What a horrible experience Ally!! :nono:


I'm SO glad to hear Zebra is doing better though!! I don't have any useful advice, but I'm sending you and Zebra lots of ::HUGS:: and dust for the next few weeks :appl:
 

iheartscience

Super_Ideal_Rock
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Messages
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Yssie|1313952256|2995804 said:
OMG. What a horrible experience Ally!! :nono:


I'm SO glad to hear Zebra is doing better though!! I don't have any useful advice, but I'm sending you and Zebra lots of ::HUGS:: and dust for the next few weeks :appl:
Ditto-what a terrible experience. Hugs to you and Zebra-that receptionist sounds AWFUL. I think you should shop around ASAP for a new vet so you'll have someone in case another health issue pops up with Zebra.
 

bee*

Super_Ideal_Rock
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thing2of2|1313952457|2995806 said:
Yssie|1313952256|2995804 said:
OMG. What a horrible experience Ally!! :nono:


I'm SO glad to hear Zebra is doing better though!! I don't have any useful advice, but I'm sending you and Zebra lots of ::HUGS:: and dust for the next few weeks :appl:
Ditto-what a terrible experience. Hugs to you and Zebra-that receptionist sounds AWFUL. I think you should shop around ASAP for a new vet so you'll have someone in case another health issue pops up with Zebra.
I totally agree. Delighted to hear that Zebra is doing better but that clinic really need to step up! You should be able to get some info on your kitty when you ring and then to be told that he was much worse when he wasn't is awful. Sending hugs to you and Zebra
 

allycat0303

Ideal_Rock
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Bee* I think the receptionist had NO idea what she was talking about. Zebra recieved 2 units of insulin and his sugar went from +30 to 6. This morning his glucose level was 10.1, he did not get any insulin because he had not eaten the night before. Then he had breakfast. I took it right before he had supper and it was 18.6. I gave him 1 unit, and fed him. I didn't give him the full two units because I was not sure he was going to eat at ALL. I think he will be ok for tonight, tomorrow I'll take another one before breakfast. He ate a whole can of food (big can) and had some cat milk. I had purchased it because I was terrified he wouldn't eat anything at all.

So big victory tonight. I'm happy he ate. His glucose is a bit high, but the vet said to aim 10-12, so it's not catastrophic. I want to avoid hypoglycemia at this point, because I'm not sure what he will eat.

Unless you think I'm being to permissive.....

Thank you so much for all your suppport, bee* !

thing2, Yssie: I'm relieved she was wrong indeed! I think its like at a hospital, you shouldn't expect the receptionist to give you 100% accurate info, as it is not their job. Usually you need to talk to the doctor or the nurse.
 

bee*

Super_Ideal_Rock
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May 14, 2006
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12,170
Sorry can only post from my phone tonight so it will be short. I think you're doing the right thing by feeding him what he wants at the moment. When his appetite is back to normal then I'd try and get him on a low carb food. Glad to hear he's eating and his BG isn't skyhigh anymore!!
 

movie zombie

Super_Ideal_Rock
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good call to take kitty home! but please get yourself established with a different vet! don't wait for another emergency. find someone you can actually trust and talk to.
 

yssie

Super_Ideal_Rock
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allycat0303|1313961651|2995925 said:
Bee* I think the receptionist had NO idea what she was talking about. Zebra recieved 2 units of insulin and his sugar went from +30 to 6. This morning his glucose level was 10.1, he did not get any insulin because he had not eaten the night before. Then he had breakfast. I took it right before he had supper and it was 18.6. I gave him 1 unit, and fed him. I didn't give him the full two units because I was not sure he was going to eat at ALL. I think he will be ok for tonight, tomorrow I'll take another one before breakfast. He ate a whole can of food (big can) and had some cat milk. I had purchased it because I was terrified he wouldn't eat anything at all.

So big victory tonight. I'm happy he ate. His glucose is a bit high, but the vet said to aim 10-12, so it's not catastrophic. I want to avoid hypoglycemia at this point, because I'm not sure what he will eat.

Unless you think I'm being to permissive.....

Thank you so much for all your suppport, bee* !

thing2, Yssie: I'm relieved she was wrong indeed! I think its like at a hospital, you shouldn't expect the receptionist to give you 100% accurate info, as it is not their job. Usually you need to talk to the doctor or the nurse.

More good news :appl:

Can I ask if you had to feed him - or did he eat by himself? And have you had any need for the subQ fluids?
 

allycat0303

Ideal_Rock
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Nov 19, 2004
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Yssie,

Thank you for asking! No he ate on his own (today too...actually he was begging my mother for food which is more his style). I did not give him any sub Q fluids as he appeared well hydrated...good turgor, producing good amounts of urine. Nose appears wet (not reliable but still!) He's doing really well. Blood sugar was 6 this afternoon, a little low, but I had given him 3 units of insulin. I think his dose is 2.

Keeping my fingers crossed!
 

yssie

Super_Ideal_Rock
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allycat0303|1314049112|2996856 said:
Yssie,

Thank you for asking! No he ate on his own (today too...actually he was begging my mother for food which is more his style). I did not give him any sub Q fluids as he appeared well hydrated...good turgor, producing good amounts of urine. Nose appears wet (not reliable but still!) He's doing really well. Blood sugar was 6 this afternoon, a little low, but I had given him 3 units of insulin. I think his dose is 2.

Keeping my fingers crossed!
Awesome :bigsmile:

I asked because I remember when we first got our stray she needed fluids, and for some reason she would keep down what we syringe fed her but not what she ate on her own. Even if I literally sucked up water from the same can of wet I'd put down for her! Maybe we just have a strange cat ::)
 

dragonfly411

Ideal_Rock
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Jun 25, 2007
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Allycat - I'm glad Zebra is doing better!

As a side note, in the future, I would find a more reliable vet. It shouldn't be just the vet that you trust but the entire staff, and they should be accommodating, informative, and they should try to relate to you. I would write a letter to the veterinarian and then I"d find another office.
 
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