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My cat is almost 12. He is a diabetic and on insulin. I

My cat is almost...

My cat is almost 12. He is a diabetic and on insulin. I don't like the way he has been acting for the past 24 hours. He's lethargic, won't eat and only drank a little. He threw up a few times. I put a bit of Karo Syrup on his gums and am waiting to see what happens. I also have not given him his tinsulin this morning. I am new to the area I live in and don't yet have a vet. The closest emergency Vet is almost an hour away. Would you have any suggestions?

Veterinarian's Assistant: I'll do all I can to help. This sounds like it might be serious. I'll let the Veterinarian know what's going on ASAP. Is there anything else important you think the Veterinarian should know about your cat?

His glucose was tested about two months ago, and it was fine.

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Answered in 22 minutes by:
1/14/2018
Dr. B.
Dr. B., Cat Veterinarian
Category: Cat Veterinary
Satisfied Customers: 22,840
Experience: Small animal veterinarian with a special interest in cats, happy to discuss any questions you have.
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Hello & welcome, I am Dr. B, a licensed veterinarian and I would like to help you today.

Now I completely share your concern here about his current signs. Diabetics are very delicate and anything that puts them off food is a worry. Now given that he has appetite loss alongside vomiting this tells us he has severe nausea and raises worries of a bacterial or viral gastroenteritis, pancreatitis, parasites/protozoa infections, general dietary indiscretion, and harmful ingestion (hopefully less likely).

With this all in mind, if his vomiting is severe then we'd want him seen now. Especially as he cannot have his insulin if he is off food and that carries further health risks for him. So, to find your local ER veterinary clinic, you can check @ http://www.vetlocator.com/ or https://www.veccs.org/facility-directory/ . Else if his signs are mild we can try some home supportive care. To start, you can consider treating him an OTC pet safe antacid [ie Pepcid (More Info/Dose @http://www.petplace.com/article/drug-library/library/over-the-counter/famotidine-pepcid), Tagamet (More Info/Dose Here @ http://www.petplace.com/article/drug-library/library/over-the-counter/cimetidine-hcl-tagamet)]. Whichever you choose, we’d give this 20 minutes before offering food to allow absorption. Of course, do double check with your vet if he has a known health issues or is on any medications you haven't mentioned. Though if he cannot keep it down due to nausea, that is usually a red flag that we need to bypass his mouth with injectable anti-vomiting medication from a local vet.

Afterwards, if he settles, you can try him with a bland diet with boiled chicken, boiled white fish, , scrambled eggs, or meat baby food (as long as its garlic/onion free). There are also OTC vet diets that can be used (ie Hill’s I/D or Royal Canin’s sensitivity) too. The aim of these diets is that they will be better tolerated/absorbed by the compromised gut. Therefore, it should get more nutrients in and result in less GI upset. As long as improvement is being seen, I usually advise continuing this until signs are settled, and then weaning slowly back to your normal diet.

Finally, as dehydration is a risk, do keep an eye on his hydration. To check that, there are a few things you can look for. Besides gum moisture, make sure his eyes aren't sunken and that he doesn’t have a "skin tent" when you lift the skin. To see how to check those dehydration signs, here is a good video ( http://www.ehow.com/video_12232503_dog-dehydrated.html ) to look at. If you do see any signs of dehydration already, that's our cue to have him seen before this becomes an additional issue (especially as it is often dehydration that makes them feel unwell).

Overall, his signs do raise some concerns and given his diabetic status we do have to be proactive. Therefore, if his signs are severe its worth having him seen now. Else we’d want to start the above supportive care now. If he cannot keep that or water down at any point, appears dehydrated already, or doesn’t respond to the above within 12-24 hours; then we'd want to get the local vet to assess him, rule out fever, make sure there is nothing in his stomach that shouldn't be there or any sinister viruses present. Depending on their findings, his vet can treat him with injectable anti-vomiting medication, fluids +/- antibiotics to head off this worsening at all.

Kind regards,

Dr. B.

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Dr. B.
Dr. B., Cat Veterinarian
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Satisfied Customers: 22,840
Experience: Small animal veterinarian with a special interest in cats, happy to discuss any questions you have.
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