Tisha DKA update - coming home!

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Tisha's_Person

Tisha's_Person

Member Since 2014
We are at the hospital with Tisha now. Sorry I haven't posted for ages, but it was because she was doing so well. For those who don't know us, Tisha was diagnosed with diabetes and chronic pancreatitis last summer. She had a very rough fall and we almost lost her, but she has not had a flare up since Halloween. Thursday, she started acting Sick. We treated it like a normal flare up and herBG was 210, so no concerns. She just seem to keep getting worse and by this morning she refused to eat anything and would not move. We took her to the vet and she has ketoacidosis. She also has a lot of pain in her abdomen and an elevated white blood cell count. Or ultrasound results at the hospital now. Depending on what they say, we may need to make a decision about putting her down. I am Heartbroken and can't stop crying
 
My thoughts are with you, there really isn't anything else I can say. I sure whatever you decide will be for the best.
 
My thoughts are also with you and Tisha as are my prayers.

I know how very hard this is to endure for all of you. I wish I had magic words but...wait to see what the results are first. You just never know and this might not be as bad as you think. It *may* be totally treatable.
And, as I typed that in...your update came through.

Hang in there...there might be a treatment for the enlarged liver. Just wait and see what the vets have to say first.
 
Tisha is staying at the hospital until Tuesday. White blood cell count is very high and her liver is coarse and enlarged, but no evidence of pancreatic cancer. We are hoping she got an infection, which triggered the DKA And not eating. We will know more when the meds get in her system. Estimated cost: $3k. My daughter said she would rather have the cat than a vacation this summer.
 
Louellen said:
My thoughts are also with you and Tisha as are my prayers.

I know how very hard this is to endure for all of you. I wish I had magic words but...wait to see what the results are first. You just never know and this might not be as bad as you think. It *may* be totally treatable.
And, as I typed that in...your update came through.

Hang in there...there might be a treatment for the enlarged liver. Just wait and see what the vets have to say first.
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The vet said the liver really could be an infection or hepatic lipidosis, but we won't know for sure until next week because there'should no one to do a biopsy over the holiday weekend.
 
I'm sure that they'll treat for infection over the weekend first and see if there's any improvement with just that step and then, if necessary, go for the biopsy.
But, hang in there. Try to keep as much of an optimistic outlook as you can and wait until you get all of the results and know what you're dealing with first. It *may* be totally treatable and you won't have to do more of the crying. :)

Still keeping prayers going!
 
Check out milk thistle extract products such as Denmarin and Marin. These help support the liver.
 
Sending lots of vines and prayers for a quick recovery for Tisha!!

The fact that her white blood count is high is a good indication of infection, and that's one of the 3 steps to DKA ...infection + not enough food + not enough insulin, so hopefully once the AB kicks in, she'll feel better and they'll be able to get her eating well again

Your daughter sounds like the kind of lady we love to hear about here!! Willing to forgo the vacation for the cat...Tell her we think the world of her around here!
 
In the hospital, they will use Humulin R in an IV and titrate the drip to the glucose levels they observe.
 
Lisa,

Tisha is in the best place she can be right now and I have no doubt that they will do everything they can to make her comfortable, get her feeling better, and get her home.

Having been through DKA and FHL with JuJu last year, I know the most important thing, along with flushing the Ketones, is to get Tisha eating again asap. Whether it's naturally, by syringe, or if necessary a feeding tube.


I encourage you to visit her in the hospital. Some CG don't want to see their fur babies hooked up to IVs and such but I promise you it's helpful to you and kitty.

Goodluck and please keep us posted.

Hugs and Headbutts,
Matt, Ava, KiKi, and JuJu.
 
The vet was less encouraging when we talked to her today. She said that Tisha's blood glucose is down to almost 200, but she is still lethargic, not eating and clearly in pain. She seemed less encouraging and I'm not sure what to think about the update. I have admit that I am very frustrated now that the initial shock has worn off because I feel like we should have caught this or at least had some inkling that it was coming. So for those of you who have been through DKA before, how do we keep her from ending up in the hospital next time?
 
And are they giving her pain meds? Those can help her be more comfortable, which may or may not help her to eat.
 
Lisa, I'm so sorry to hear that Tisha's in hospital. Keeping you both in my thoughts and prayers. Our vet has Saoirse on a SAM-e & milk thistle supplement for her liver.
 
Lisa,

I completely understand what you mean. I was beside my self when JuJu was admitted with DKA. I cried and cussed my self for 24hrs straight. How could I have allowed this to happen? I'm a terrible person! The doctors, techs, friends and family all told me not to beat myself up. There's no way I could've known he was that sick. DKA doesn't really present itself until it's already full blown and very serious. It can go south very quickly. So, I pulled myself together and started preparing for JuJu to come up. Through research is how I found this wonderful place, the FDMB.

Now, having been through DKA and having time to reflect, I feel like I missed some potential red flags. When kitty starts to look for an alternative water source (JuJu started drinking from a leaky bathtub faucet) that could be a sign of dehydration. I chalked it up to him just being a butthead. Now I know better. That's actually how we got him back on insulin just recently. My wife caught him drinking from the bathtub, immediately tested his BG (300) and got a ketone test asap. Thankfully, no ketones but we knew he had to see the vet immediately and resume insulin.

Probably the biggest red flag is sudden weight loss. That can be hard to tell because you see kitty everyday. I suggest, at minimum, weekly weight checks. The last figure I remeber reading is that kitty should not lose more than 2% of their body weight, weekly. And if kitty doesn't eat for 24hrs, it's a good reason to see the vet.

Sometimes things are out of our control but I certainly believe if we stay observant (we have to know what to look for), we can increase the chance of a positive outcome.



How is Tisha? I hope she has improved. Try not to get discouraged. JuJu had a couple days that he took a step back but then took two steps forward. It takes time for the treatment to work. Please let us know how she's doing.


Hugs and Headbutts,
Matt, Ava, KiKi and JuJu
 
We went to see Tisha this morning. Her BGreat is still okay, but her ketoneso are back up. They increased her insulin and started syringe feeding her. The vet said she is not worse, but not better. They repeated the ultrasound and her liver and pancreas are still "very dark" and enlarged. She has to eat, so they have all kinds of food available. She let me hold her without complaint, but was less responsive today.
 
Hepatic lipidosis can be cured with food and infection with antibiotics. It takes time though if pancreatitis is part of the puzzle I hope they are treating with cerenia and buprenex for pain. All of this is serious but can be treated aggressively with a good outcome. Hang in there. :bighug:
 
JuJu09 said:
Probably the biggest red flag is sudden weight loss. That can be hard to tell because you see kitty everyday. I suggest, at minimum, weekly weight checks. The last figure I remeber reading is that kitty should not lose more than 2% of their body weight, weekly. And if kitty doesn't eat for 24hrs, it's a good reason to see the vet.
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Unfortunately, we have been fighting weight loss for almost a year due to the pancreatitis. We finally had her up enough to look healthy about 2 weeks ago and had not seen a flare-up since late October. Her insulin dose was fairly stable for the first time ever, and she was just doing well all around. I guess we let our guard down a little, but there still weren't many warning signs. The only thing I remember was her peeing on a plastic bag last weekend. We used to have a lot of litter box issues, but it had been a long time, so we just cleaned or replaced all of her boxes and litter and didn't think it might be a red flag.

Honestly, waiting and not knowing or doing anything is hard. I wish I had my crystal ball so I knew what her quality of life will be and how to best help. We took up all of the foods we have ever gotten her to eat today, but still no luck.
 
In response to BP and:
tiffmaxee said:
Hepatic lipidosis can be cured with food and infection with antibiotics. It takes time though if pancreatitis is part of the puzzle I hope they are treating with cerenia and buprenex for pain. All of this is serious but can be treated aggressively with a good outcome. Hang in there. :bighug:
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She is on cerenia, buprenex, mirtazapine, zofran, humulin r, unasyn and pepcid. Steroids and Lantus were added today.
 
Sounds like they're being aggressive with treatment, which is good.

If they added Lantus, that would indicate Tisha has flushed the Ketones, yes? That's how they treated JuJu. They didn't start the long acting insulin until he was ketone negative.

Also, JuJu had to be syringe fed for 4 days. His FHL was to the point that the 2nd day in the hospital he started developing jaundice. I'm not trying to make you nervous, I'm just letting you know that with aggressive treatment, and time, Tisha can make a full recovery.

We're all in your corner.

Hugs and Headbutts,
Matt, Ava, KiKi and JuJu.
 
They are giving all the right meds and hitting hard which is a good thing. Mirtazapine did not work well for my cats and cyproheptadine did. We are all rooting and sending prayers. :bighug:
 
JuJu09 said:
If they added Lantus, that would indicate Tisha has flushed the Ketones, yes?
Click to expand...

Unfortunately, no. Her ketones were higher today than yesterday. They added Lantus to help control BG with the syringe feedings. They also increased humulin r. They will retest in the morning. Current bill: $2,000. Ouch!
 
We just went to see her. She seems to be perkier than she was this morning. She let me hold her and purred for a while. She was also looking around to see what else was going on outside of her cage. She just seems to be more alert. I did notice that her BG is up on her chart. I hate the back-and-forth of how she seems to be better then she seems to be worse. She is still not eating though.

By the way, I apologize for the typos. Siri is typing most of this since I don't have my laptop on this weekend.
 
Hi Lisa,

Very glad to read that Tisha's perkier today. I know what you mean about the roller coaster. I feel for you.

Sending hugs, scritches, and prayers.


(((Lisa and Tisha)))
 
I talked to the vet this morning and she said that Tisha really isn't getting any better. She was not at all encouraging, so I went to work in tears. I sort of managed to come to grips with the notion that we may need to put her down this week. At lunch, my husband went to visit and said she was doing better. I just got off the phone with the doctor and she said that Tisha is much stronger. She is walking around and showing some interest in food, although she's not actually EATING it yet. They are being more aggressive with the insulin, and have finally gotten her consistently under 200. (It's sort of amazing to see how much difference it makes in her behavior when her BG changes.) She thinks she will come home tomorrow. So, ultimately good news. :cat:

So, any suggestions for a way to monitor her weight without spending a small fortune or traumatizing my cat with a trip to the vet every week? Weighing her on my scale is completely ineffective. It looks like we may need to monitor weight and food intake for the next several months to intervene sooner and keep her out of the hospital when she has flare-ups of pancreatitis.
 
What a day!

(((Lisa)))

I'm relieved to hear that Tisha's responding to the insulin and will hopefully be home tomorrow. What scales are you using, Lisa? I've got a digital baby scales and it works a treat for monitoring Saoirse's weight. Here's the one that I have:

http://www.ebay.co.uk/itm/BN-DIGITA...715?pt=LH_DefaultDomain_3&hash=item33a12af37b

I also record the food type/qty/calories Saoirse eats every day in her spreadsheet. The secondary monitoring has helped me manage Saoirse's weight fairly well. (Much easier to catch when she's lost weight when her appetite has been wobbly.)

WRT ketones, from what I've read here, ketones show up in the blood a good bit earlier than in the urine. I think a blood ketone meter would help you with monitoring. Hopefully other members will be able to tell you more about ketone meters.

I hope that you will be able to get some sort of decent sleep tonight, ready to welcome your little one home tomorrow. Sending prayers, hugs and appy stimulant vibes.

:bighug:
 
I have a Salter baby scale 914 that I bought on Amazon. It works really well and you can measure in metric or lbs. I highly recommend it. It's digital and I paid about $50.

Ask for a prescription for cyproheptadine (human appetite stimulant) and one for ondansetron and make sure that you gave enough cerenia when you bring her home. Some cats do better with ondansetron, some with cerenia, and some need both. The trick is to find the right drug or drug combo that gets the appy back. Then don't feed too much at any one feeding. Small amounts often if possible U.S. The best, spread out over the course of 24 hours you want her eating at least 50-75% of normal at first.
 
She was also up and walking around and thinking about jumping down from her cage. Quite a change from yesterday morning! The vet said she could come home tomorrow if she keeps eating.
 
A luggage scale attached to a towel might be an easy way to check the weight. When she comes home, try to get her to eat at least a 5.5oz or 6oz can of food a day. There are some higher calorie wet foods available, anything >200 calories a can is high calorie.
 
She is now home. We were a little worried because she didn't eat for my husband, but I tried a new can of food when I got home and she ate almost all of it. (Of course, I only have one can of that food and the pet store is closed...)

She is back on Lntus, but her PM was high (358). I will probably retest soon.
 
That's great news!

Hopefully, the doc sent you home with an appetite stimulant. I believe some of the FDMB members gave you some suggestions on which ones they like. It's not popular around here but, Mirt worked well for JuJu. We just gave him a single dose (1/4 pill) and he started eating like a lion.

There's also some tips/tricks to help get a happy appy. Happy Appy Tips/Tricks
 
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