HELP!!! Time is running out - cat has DKA! :(

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Chloe'sMom (GA)

Chloe'sMom (GA)

Member Since 2015
Hello all- I found this forum after researching what if anything I could do for Chloe from home. She is 12.5, a diabetic for 2 years and as of Monday started acting very odd. The vomiting started before that, when I changed her food (back to wet) last week. It persisted and I noticed bile and thought her tummy was just upset with the wet food. Well, Monday she didn't eat much and so Tuesday I took her the vet (new vet - new city, etc). They weren't able to extract any urine from her bladder so they did a serious of blood tests and thought it might be fatty liver disease. Gave her some anti-nausea meds, and an appetite enhancer and fluids under her skin and said for me to try to get her to eat as much as possible. By this point it was probably 12-24 hours of POSSIBLE not eating. The rest of Tuesday and into Wednesday she didn't eat and barely would drink. I know her habits as a diabetic and this is NOT normal. She is small, but eats like a bear. I took her to the emergency vet on Wednesday AM when she was super lethargic and acting so odd. Found out that it was her appetite enhancer making her eyes weird, but that she was lethargic from DKA, etc. They suggested to keep her over night so that they could get IV fluids and insulin going for her. $1000 later (plus the $300 from the other vet) and we just couldn't afford to keep her there anymore. I picked her up around 2pm (against the ER vet's wishes - and they suggested home would be hospice-like care) and we've been home the last 3.5 hours and she is sitting staring out the back patio, which is GOOD. She has been just staring out into space a lot. 30 mins ago I just fed her 15ml of plain pedialyte and 7ml (most I could get in her) of cat food gravy. I'm desperate. I don't have the $5000 or so to keep her overnight for days on end and I'm afraid I'm going to lose her!!!! Any advice? I've reached out to the vet I took her to on Tuesday and I'm just waiting for them to contact me with any ideas of how to get her eating and maintain her insulin.

I'm open to suggestions from people that have had a cat with DKA. Please and thank you!
 
You have a rough road to travel. We'll give you the best information we know.
Ketones form as a by-product of fat breakdown for calories. this happens when the cat cannot use the glucose from food that has been eaten.

1) In order to monitor your cat, you must get an inexpensive human glucometer, such as the Target Up and Up or the WalMart ReliOn Confirm, matching test strips, and lancets (alternate site testing ones are best as they are 25-28 gauge and easier to get blood for the test). Check You Tube for videos of the process.

2) fluid intake - offer plenty of fresh clean water, add some to the canned food and mix well. This helps flush the ketones out.

3) food - right now, anything she'll eat works. Plain baby food with nothing but meat and water works, and is easy to syringe. You must get the food in

4) insulin - what insulin do you have? How much are you giving?
 
Thank you BJM. I have a glucometer and just spoke with another vet (there is a group of them) in our practice and she advised of syringe feeding which I had done since Chloe isn't eating on her own. I've given Chloe about 25 ml total or so of food in the last 2-3 hours. Vet recommended only 1 unit of the insulin. Lantus is what we have. We're desperately trying to save her. And while the money for the MedVet Emergency vet 24/7 care is not readily available to us, we are doing our best. Apparently the vets while helpful, are surprised we're willing to do so much.

BJM, are you in Columbus Ohio? I am too - ironically. We have been treated at the Easton Animal Hospital and at MedVet in Worthington. I'm praying she makes it through, though we have been told that it would be unfair to keep her much after 24 hours if she hasn't improved. :'(

Thank you for your help and any other suggestions is appreciated! What are your thoughts on Pedialyte?
 
Yes, I am in Columbus. Plain Pedialyte may be OK; the most crucial electrolyte needed is potassium, as the insulin uses it to work. Did the vet do blood work and test the potassium levels? You may need to take her in for testing that and general blood work tomorrow.
I'm in NW Columbus. You?
 
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See my signature link Secondary Monitoring Tools for testing dehydration.

I sent you my phone #. Look up in the upper right.

 
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BJM - thanks! I appreciate your kindness. Have you had or known of anyone to get their kitty out of the DKA state? And Pedialyte has potassium, which is good. Yes, vet checked and I'm actually trying to remember - it may have been a little low and they supplemented before I picked her up from the ER. I wish I had thousands to have them care for her there... :(
 
She is still purring when petted so I'm hopeful that she is still somewhat alert to know that I'm there. She is on Mirtazapine to stimulate appetite which so far the last couple of days has not worked. Forcefully feeding her is the only way that I've gotten nutrition in her. She has licked a few licks of gravy once or twice, but that is about the extent of it. I don't like how the Mirtazapine has made her feel/look. She's so groggy so it's hard to tell if that is the DKA or the drugs. The vet that is at the practice we go said that she thinks it could be either way, but knowing that Chloe exhibited these behaviors the other day when on it, makes me think it's the meds: large pupils, odd behavior (splashing water around, sitting in her water bowl, etc). I know she feels sick and I think that drug is making it worse. For now, we have been recommended to syringe feed her and get her peeing those ketones out. That is the ONLY way she will get better is to eat and get those ketones out. I know it is unlikely, but I'm still remaining hopeful. Any advice and thoughts are so welcomed. And thank you.
 
Toward the bottom of this article is information on financial help. Care Credit is a resource many people have used. DKA is very difficult to treat at home given the need for monitoring electrolytes and titrating insulin.
 
Can you give her subq fluids at home, too? That would help flush the ketones and keep her hydrated. You might also ask about trying Cyproheptadine instead of Mirtazapine. It doesn't make kitty as wild-eyed and it works better for some kitties than Mirtz. Be careful not to syringe too much food too fast - it might make Chloe throw up. Space the feedings out a little. Use a food that is high calories, but watch the fat content, as that can also upset the tummy. My Cinco was in DKA when we first took him in. That was 4.5 years ago. Sending you lots of prayers and good thoughts.
 
Food, fluids and enough insulin are important for DKA. It happened w/ Tess about 2 months ago when she wasn't eating. She was at the ER for 2 nights on an IV drip w/ R insulin. When we got her home we gave sub-cutaneous fluids every day and got R insulin to use as a bolus to bring high numbers down. Her improvement is amazing, bright eyed, alert, eating well even demanding it in the morning! She has also gain nearly half a pound back. So yes they can come back from DKA. The fluids have been really important in her recovery.

Good that your vet is suggesting syringe feeding. Your vet should be able to set you up and teach you how to give sub-cutaneous fluids at home. Talk to your vet about getting R insulin to use as a supplement. You can get R insulin at Walmart pharmacy for about $25 (anywhere else it's over $100, they have a special deal w/ the maker) and no prescription is needed. Advisors here can help you work out a scale on how much and at what point to use it. The ER vet thought it a good idea, but recommended 1 unit, we usually only give her 1/10th of a unit!

I just saw Tricia's post, you can get the Cyproheptadine at Costco pretty cheaply and the Ringers for sub-q fluids too.
 
Here is a good information post on DKA/ketones. It's going to be helpful for you to have a good understanding of what's going on in her body so you can understand how to help her.

At the bottom of that post are some links to posts that have info that might help you where another cat was dealing with ketones.

Sending healing thoughts to Chloe. And yes, many cats do recover from DKA, but it's a very serious situation.
 
If you are able to check her sugars and post here, that would be very helpful. DKA happens due to not enough insulin (amongst other things) and you need to be able to safely increase insulin to reduce those ketones. Increasing insulin could cause her to go low if you are not testing. Ketone strips will help you track if she is improving, and you can buy these over the counter at most pharmacies.

For feeding, try to get in her one 5.5oz can of food and 300ml of water a day. Syringe feed every 2 hours or so, you may need to do this around the clock for a couple days. For calories see if you can get Iams Max Cal from your vet. You can ask your vet to show you how to do subQ fluids at home, it's not much harder than giving insulin once they show you. Your cat will need electrolyte labs, because if potassium is low this will prevent recovery.

What dose of insulin was your cat on prior to the DKA?

I'd ask for an anti nausea instead of the mirtazapine, in DKA usually nausea is the barrier to eating. You may have to taper the mirtazapine in order to get rid of it.

Cats can and do recover from DKA, but it's a marathon for a few weeks. More food and more insulin is the key.
 
Wow, thank you everyone. I have a log of what I've been doing and she was last syringe fed at 9:45pm. I'm setting my alarm for every 30-60 mins to keep an eye on her. I've given her pedialyte too. I gave her 1 unit of insulin around 7:30 per vet's orders. Now the emergency vet thought she should have stayed with them, but the cost was just so high. We can't afford thousands. I'm ashamed to admit that. But her home vet group is trying to help - however they suggest that if she isn't better tomorrow, that we consider euthanasia.

Just checked her glucose and it was an alarming 332. And that is after the 1 unit at 7:30. I wasn't expecting it to be so high!!! I'm about to syringe feed her again. Since she has been home (2pm) she has urinated only 3x plus once in her carrier on the way home. I'm giving her water and pedialyte regularly. I know this will be a long night and I'm thankful for all of you for help!

I did ask for the Cipro, but it seems these vets like to use the Mirtazapine. I don't plan to give her any more if I can help it. I think more anti-nausea may be good?

Her syringe food is a can of Fancy feast seafood with a packet of kitty gravy and water. I have small 3ml syringes and I try to give her 12-15ml each time but it's getting harder and harder. It is weird to watch her with the food on her face. Normally she would be cleaning herself. I'm trying not to get scared, but she seems like she is in just a lethargic state. I'm willing to do all I can. Thankful I work from home and can monitor her. With this though, work has been put on the back burner. I'm not ready to lose her yet, but I don't want her to suffer either!!

I don't have anything to check her ketones. I know that is why she is not eating. Poor thing has slowly lost over 2# since September when she has a similar, but much milder, episode with the emergency vet. Please keep sharing ideas and at 1am I'm doing all I can! Now for more syringe food.
 
Oh and she was on 3 units 2x a day before - but I had taken her off last week as her glucose was in the 180s and she was eating low carb foods - which are preferred. I feel this catapulted this DKA, but the vet seems to think this has been and issue for a while. I've now learned that I have to ween things, not cold-turkey it.
 
I don't really have a good idea about her pattern of sugars, but if you are at 3U a week ago, and now 1, she probably needs an increase. If you could check the sugars every 2-3 hours tonight and post in the am, I'd feel more comfortable saying increase by 0.5ml, but see where she's at first. 180s are good numbers, you don't need a reduction if you are in this range when testing from 6-10hrs after the shot. Low blood sugar in a cat is 50s and below.

She's not going to be better by tomorrow, DKA doesn't work like that. It takes at least a week, sometimes 2 for them to start acting better and eating better. Low potassium and dehydration can contribute to the lethargy. Ask about testing the potassium and getting potassium powder to add to the food you are feeding. My cat Max was very sick with DKA when he was first diagnosed. He was like a limp rag the first couple days. Took about 2 weeks, but now he is fine with no lasting effects. The potassium, subQ fluids, syringe feeding, and cerinia (anti nausea) were are critical to his recovery.
 
No advice from me just a huge welcome and a note to let you know that you have found the place where plenty of former DKA kitties have recovered and Chloe can to. You do not have to euthanize her. Just hang in there and keep posting so folks can help you.
 
I don't have experience with DKA but I just want to say I think you're doing a great job of being there for your girl, and I'm sending lots of vines your way. The experienced people here are very knowledgeable about these issues (more than a lot of vets), and you are getting a lot of good advice. I would keep doing what you're doing and try everything people have suggested. We are pulling for you.
 
The odd thing is that at home before this, she was at 180-183. They had her on an IV and insulin CRI and now she's spiked. Not sure why. It could be because she now has food in her system. She had food in her system when it was in the 180s too. Vet had said that if she had 10-15ml more of syringe food in the AM that she was ok with 1unit then too. I will check it again in a couple of hours. I just fed her about 12-13ml of the food/gravy/water mixture. She was pretty good this time, but towards the end, she starts spitting it out a bit. I'm trying to give pedialyte every so often because I know it has potassium too. I will ask about the subq fluids, more anti-nausea (they gave her cerenia the other day at the vet -not ER), Cipro (though they'd said it wouldn't work any better than Mirtazapine) and thing others mentioned above.

I agree, she may not bounce back right away, but I'm fearful I won't have vet support unless she is at least somewhat better tomorrow! I'm willing to do all I can. The last few days have been s nightmare and I've cried more than I can remember. I am willing to fight for her if she is!
 
Deanna & Billie said:
I don't have experience with DKA but I just want to say I think you're doing a great job of being there for your girl, and I'm sending lots of vines your way. The experienced people here are very knowledgeable about these issues (more than a lot of vets), and you are getting a lot of good advice. I would keep doing what you're doing and try everything people have suggested. We are pulling for you.
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Thank you!!!!! I hope I continue to get vet support - I just need my Chloe to do better tomorrow otherwise they are pulling for euthanasia.
 
Linda and Scooter & Jack said:
No advice from me just a huge welcome and a note to let you know that you have found the place where plenty of former DKA kitties have recovered and Chloe can to. You do not have to euthanize her. Just hang in there and keep posting so folks can help you.
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Thank you! You all have been so supportive and I am soooooo grateful. You have no idea at 2am how this just makes me feel. Thank you thank you!!!!
 
The mistake vets make is to pull back on insulin when a cat stops eating or is eating poorly. Often this can trigger even worse appetite and DKA. With ketones, any reduction in insulin will make the body produce even more ketones. Of course, you want to make sure a hypo doesn't occur as well. You can mix honey or syrup into her food to keep her sugars up if needed in order to give more insulin. And test BS at least every 4 hours.

If she doesn't get enough insulin to change her metabolism back to normal, the DKA won't improve.

Good luck at the vet. Make a list of supplies you'd like to have at home and see if they will give them, after that, it's possible you are on your own (and FDMB will still be here) if your vet doesn't know how to treat DKA.

If your home vet won't give you fluids/anti-nausea/potassium and test for it maybe the ER vet would be willing to do this.
 
Ok. I wonder now with her higher glucose levels if she needs more. I wil mention it to them tomorrow! I know they know how to treat it, definitely, but I think that they think she is beyond repair to some extent. She has high ketones - checked again Thursday morning. But - sounds like we can manage them. Also, she was not eating etc at the ER and when boarded or any other time at the vet, she is so extremely stressed. I think with their guidance and with her at my home, we can do this. Good thing, my vet group is only 1/2 mile from my house! My home vet is way more receptive to home care than the ER, but I found out that they are colleagues and well, they worry that Chloe will be in more pain or unable to come out of this with home care. However, the home vet said that DKA can be cured 60-70% of the time, but she said it's with careful management, which is hard to do at home. I will keep trying!!!!!! Thank you!!
 
Hopefully that made some sense at 2:30 with a loss of sleep!

Meya- do you have recommendations for how much I should feed her/give pedialyte and how often? She just urinated again which is good!!!
 
Your goal is one 5.5 or 6oz can a day. So split it up every couple hours so she doesn't get too nauseous from it, however your schedule allows, maybe every 2-3 hours. 300ml of fluid is the goal, but that includes fluid in wet food, so if you get close to that you are doing good. If you can get your hands on any IAMS Max Cal, that would be helpful as it is very high calorie.

Make sure the pedialyte doesn't have xylitol in it because it damages cats kidneys.
 
Chloe'sMom said:
I just need my Chloe to do better tomorrow otherwise they are pulling for euthanasia.
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That is not their decision to make and they shouldn't try to force you into it. They can advise, but they can't make you euthanize your cat. And only giving her 24 hours to recover from DKA isn't very realistic on their part. As long as you can give her the care she needs - food, fluids and insulin - and are prepared to put the time she needs each day into helping her recover then they should be prepared to at least let you try even if they don't necessarily approve. Good luck discussing it with them. :bighug:
 
6:55am and Chloe's glucose is at 222. She's urinating every 4 hours or so. Wondering if I need to up her pedialyte or water more? She's been tired too and I have tried to give water, pedialyte or food every 1-2 hours.
 
You're doing a good job of helping Chloe. My kitty J.D. was a DKA survivor. He had it when he was 11 and lived to be 20.
Good luck at the vet today. I hope you get all the supplies you ask for. Keep getting the food and the fluids in.
If you get R insulin, you will need to test a lot, so have plenty of test strips and have someone experienced with R here, help you and guide you. Vets seem to only be used to 1 unit increments. When I used R, I did 1/10th unit.
You can buy ketone test strips at the pharmacy today.
 
I'm not knowledgeable with DKA but just wanted to say you're doing a great job and are in good hands with this community. Been thinking of you and Chloe all night and am rooting for you both!
 
missMeows said:
I'm not knowledgeable with DKA but just wanted to say you're doing a great job and are in good hands with this community. Been thinking of you and Chloe all night and am rooting for you both!
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Thanks
I so much! Hubby came in before work and thought she looked a bit better. Still very groggy and she's very lethargic still, but we are hoping and praying for the best!! I'm being optimistic and we are on board to help her all we can.
 
Here's my list for the vet- do I need anything else? :
R insulin
Larger syringe for feeding
Iams max cal food
Test for potassium
Potassium powder - or ask if pedialyte is ok
Subcutaneous fluids for home
Cerenia
 
The R insulin might drop the sugars too fast and needs to be titrated pretty tightly. IMO It's better to leave the R to the vets where she can get a constant IV with dextrose. Others here might feel different. You can increase the lantus and that should be able to eliminate the ketones. Most vets won't give R for home use, but it is available without a perscription at pharmacies. I'd try some lantus increases before I jumped into R.

Here's where we are at for people following:
7:30pm - 1U (was on 3U twice a day a week prior)
1:17am(?) - 332
4:20am - 251
6:55am - 222
 
Her blood glucose levels (BG) may be elevated if there's an infection. Infection/inflammation elevates BG. An antibiotic may be needed.

If you're feeding "kitty gravy" (you mentioned this above), that may be elevating BG, as well. Frankly, calories are very important in combating DKA. The MaxCal is a good option since it's calorie dense.

Cerenia or ondansatron will help with nausea and/or vomiting.

Please do not add potassium without having blood levels drawn. Too much potassium can cause almost immediate diarrhea (and hence, dehydration and further electrolyte imbalance) and can cause massive cardiac problems. It's not a trivial supplement. Phosphorus levels are also affected by DKA. You need electrolye panels drawn.

If there is any way your vet can trim costs and help you out with this, it may be safer to have your kitty hospitalized. I know it's expensive-- I went through this with my cat at the time she was diagnosed. There's no easy way for you monitor electrolytes at home. The typical regimen is for a cat to be getting a basal insulin (like Lantus) coupled with a fast acting insulin (such as Humulin R -- it has several other names) while on a dextrose drip and while getting fluids. These are not things you can do easily at home.
 
First - HUGE HUG! Yep DKA stinks! You're not going to be able to bring her potassium levels up much with the pedialyte. It can keep it level where it is but can't increase it much. I'm glad you're having the potassium level checked....
 
Meya14 said:
he R insulin might drop the sugars too fast and needs to be titrated pretty tightly. IMO It's better to leave the R to the vets where she can get a constant IV with dextrose. Others here might feel different. You can increase the lantus and that should be able to eliminate the ketones. Most vets won't give R for home use, but it is available without a perscription at pharmacies. I'd try some lantus increases before I jumped into R.
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The prescribing information
http://products.sanofi.us/lantus/lantus.html#section-16
for Lantus includes
LANTUS is a long- acting human insulin analog indicated to improve glycemic control in adults and pediatric patients with type 1 diabetes mellitus and in adults with type 2 diabetes mellitus. (1)

Important Limitations of Use:

  • Not recommended for treating diabetic ketoacidosis. Use intravenous, short-acting insulin instead.
R is the best. It can be give subQ. If you use small doses it is safe to use. Lantus really is not suitable since it acts slowly.
 
Chloe'sMom said:
Thank you! You all have been so supportive and I am soooooo grateful. You have no idea at 2am how this just makes me feel. Thank you thank you!!!!
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actually I do. The wonderful folks on here stayed up all night with me and guided me to save my Scooters life one night. I know how wonderful and affirming it is to find this place.
 
Hello all - just a bit of an update. Busy morning and early afternoon and we've been ALL over the board here.

Quick update from the vet: gave 200ml subq fluids and sent me home with enough for 800ml more for 4 more days. He didn't feel the need for potassium or to check it even - saying that the fluids should be enough and that the pedialyte would supplement also. Came home around noon after buying ketone strips from CVS and got settled. We had given her 1unit of Lantus at the vet and he didn't feel comfortable with giving the R insulin as it would be more difficult to maintain, etc. He said her temp was lower - giving him concern and the whole time he had a look of great concern on his face. This obviously made me question what the heck I was doing. I shared info with hubby who also wondered if we were being futile with our efforts. He gave her a shot of Cerenia and recommended that I stick with the Mirtazapine - not what I wanted, but he preferred it. I don't plan to give her more at this time. He gave me a Royal Canin high calorie food and larger syringes that I mixed with a tad bit of water and gave Chloe about 45ml of food, or approx 1/8 of the can (large can). He said we need to try to give 1 can a day like mentioned above. He listened to her heart and lungs and said that they sounded good, no raspy breathing, and then lifted her skin to check hydration. Being off of fluids she obviously was a bit dehydrated. He just left it with: that if she was to get worse, that we wouldn't make her suffer any longer.

Hubby was concerned with her when he came home for lunch and saw how out of it she was. She even smells sick; it's sad. We have the food as I mentioned above and he was very solemn with her with worry and then left to go back to work. Fifteen mins after he left she was sitting at the back patio (I have the screen door open for fresh air) and then suddenly she was sitting partially in the door track - very odd. I've tried to open the door to let her roam, but she's had no interest. This time however- she went outside! She sat on the back mat in the sun and seemed very content. Then, she started acting a bit more like herself and even started sniffing around, cleaned her face for a few seconds (I've not seen this behavior in DAYS) and even was curious enough to go down one of the steps and look around. She is very wobbly - obviously very sick still, but she was interested in looking around. She partially fell into me, so I'm glad I was sitting there. She would've toppled down the stairs. Then, about 20 mins later, we went back inside and when the dog passed her to go in, she cried at her in normal fashion. Her cry is weak and she sounds sick, but it was nice to see her annoyed by the dog. lol

She then urinated and I saw how dark yellow her urine is! It is concerning, but she hadn't urinated since 6:43 this AM - so several hours. (She was stressed at the vet even though I tried to get her to go). I used the CVS ketone strips and either something is wrong with them, or something else is wrong with her, because they read out at "trace" amount of ketones. That doesn't make sense! I went onto check her glucose - she had 1 unit of Lantus at 11am- and her level was the lowest ever that I've seen - at 155. I've been giving pedialyte and water trying to keep her hydrated. She's resisting the syringe more which is good in some ways (she's getting more feisty like herself) but bad in others because it's harder. She's way more alert now that the Mirtazapine is wearing off and I'm hopeful again. What a roller coaster! Just checked her glucose at 3pm and it's now 162. And wow, I could see a lot of veins in her ears this time! I'm not sure what to think of all of this? I know the Mirtazapine is a goner - she's becoming more and more like herself, but I can't get her to drink out of the faucet (her preferred method lately) or bowl. I'm having to use a syringe. In some ways we're getting so much better, in others, we're the same or worse. Thoughts?!
 
Larry and Kitties said:
The prescribing information
http://products.sanofi.us/lantus/lantus.html#section-16
for Lantus includes
LANTUS is a long- acting human insulin analog indicated to improve glycemic control in adults and pediatric patients with type 1 diabetes mellitus and in adults with type 2 diabetes mellitus. (1)

Important Limitations of Use:

  • Not recommended for treating diabetic ketoacidosis. Use intravenous, short-acting insulin instead.
R is the best. It can be give subQ. If you use small doses it is safe to use. Lantus really is not suitable since it acts slowly.
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I understand - and while I agree based upon the text, my vet didn't want to prescribe it. Her glucose is down a bit, and the ketone strips say trace, but I'm fairly certain those strips have to be wrong. I tried 5 of them to be sure, but I'd be amazed if she's pulling out of this already... Doing all I can in the meantime!
 
If you wish, I can come over for a bit this evening and give you a hand, or a break so you can get some rest for an hour or two. Look in the upper right corner of the screen. There should be a red blip over your inbox. Click on that. I sent you my phone #.
 
f
BJM said:
If you wish, I can come over for a bit this evening and give you a hand, or a break so you can get some rest for an hour or two. Look in the upper right corner of the screen. There should be a red blip over your inbox. Click on that. I sent you my phone #.
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Thank you for the offer! I told hubby he might need to do the night watch tonight, lol! :)
 
Ok, folks, I'm worried. I know there are highs and lows, but I'm hoping someone can tell me if this is normal? Her glucose is managed right now about about 152-162 for the last few hours. She hasn't drank anything on her own since 6:55am. I've either been giving her pedialyte here and there or syringes of water. Hubby went out to get new ketone strips to verify against the others, but she hasn't urinated in a few hours (1:47p) either. She's now wanting in the windows (they're open) and she's more her feisty self when giving syringes. Gave pedialyte at 2:14 pm, 2:45 and 5:30 (after a long night, I ended up zonking out a bit longer than I wanted to).

She just had about 25ml of pedialyte but again, no interest in water bowls or faucet. HELP? What should I do????
 
When the glucose is well controlled, and the food being given is wet food, the cat tends not to drink very much. This can be OK.

Check for dehydration:
1) Gently lift the skin at the scruff of the neck and release. Does it immediately snap right back down, or does it stay pulled up and s l o w l y return to where it was? If it snaps back, good. If it stays pulled up, or tented, then there is moderate to severe dehydration.
2) If #1 was good, now check the gums. Lift a lip and gently press your finger on the gums. Notice how they feel (moist, sticky, dry?). Remove your finger and watch. The pressure gently pushes out the blood; releasing that, the area should pink right back up if hydrated. It may stay blanched or pale and slowly turn pink again if slightly or moderate.y dehydrated. Also, if the mouth is dry/sticky, the cat may be mildly to moderately dehydrated.
 
BJM - Thanks for the info. Good to know!

It take about 1 second or so to go back down. I checked just below her collar and then removed her collar and closer to the back of her head, it took 1-2 seconds. I will check gums in a few moments.

I called vet with worrisome when Chloe urinated at 5:50 and then sat in it. I know she's weak, even though she's shown several signs of improvement today. During that call the vet shared that he would prefer NO ketones and that we should continue with the fluids. The tech/assistant spoke to me the most and said that this can take 1-2 weeks. (As I've read here) During our phone call, Chloe had her first BM since Monday! Now it did take her a while, as she was constipated, and the feces looked a bit odd in comparison to what she normally has, but I'm pretty sure that's because it had been compacted. I shared Chloe's glucose over the last several hours of 155-162-152 and she was so thrilled she said that she would share these things with the vet. She gave me hope and thought that for us to continue to syringe feed Chloe through the weekend was not irresponsible. I told her I am SO glad that I didn't listen to that MedVet Dr (no offense to him) and euthanize Chloe. I told her that I had to do everything in my power and home care was part of it.

Already I'm glad that I continued to push on and try all options. I hope that I can get Chloe to eat and drink on her own, and maybe the constipation was part of the reason why she wasn't, but while I know we are not out of the woods yet, I will continue to push forward with renewed hope and strength in hopes that I can save my precious Chloe!!!
 
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