Possible DKA

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MClarke087

MClarke087

Member Since 2016
I'm updating Dennis's SS after I make this post. He won't pee for me so I don't know for sure but I think he's showing signs of DKA. Is that possible if his BG has, on average, been low? He used to ALWAYS be above 600 (for months) and he was never DKA. Now he's showing numbers from the 100s-300s on average (before shooting).
This morning he was given food and insulin. I just realized he threw up all of his food. And he's continued to throw up small amounts over the last 3 hours. He seems off balance in the rear end. He is very grumpy and laying down in odd places. He wants to be left alone. He has pooped a couple times in the last 3 hours which is odd (he's straining but successful mostly). He won't pee so I don't know how to check for ketones!
What should I do?? How do I check for Ketones if he won't pee?? I can't afford the ER.
 
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A cat with DKA usually won't eat so that wouldn't be my first guess but anything is possible. I would however keep testing him to make sure he doesn't drop down into low numbers after throwing up. How long since his shot in hours? Lowest point in a cycle is usually between +4 and +6 with Vetsulin. Will he eat now? I'd try to get some food into him.

The only way to check for Ketones without pee would be to get a glucometer that also measures ketones and there are only a couple of them on the market.

If he is pooping more than usual, it could be a tummy upset. If he is straining, what is the consistency of his feces?
 
BG updates:
+2...370
+3.....219
+4....174


The vet isn't concerned with DKA but they said he needs to be seen. There is a vet that has offered to stay open late to see him. He's never been there before but I think this is what we need to do...... Something is very wrong. He's borderline lethargic.

He's been straining a lot recently and he's also gassy when he strains. I've been incorporating Miralax in his food to see if it helps. So far, no luck. His poop is darker than it should be but the consistency seems kind of normal and soft.
 
He's really weak and shaking a lot...His appointment isn't for 45 minutes but I feel like he's getting worse FAST
 
Thinking about and praying for u both as u go ....and that this wonderful vet will have extra insight and wisdom as to how to treat Dennis....so so glad u found a vet willing to stay open ...
 
Sounds like a vetty visit would be a good idea.Perhaps he's got cramps and that's why he's so lethargic. If you think he's getting worse, pop him into his carrier and arrive early. The vet knows you're coming anyway so they should be able to look at him right away.
 
On my way to the vet now. I won't update much while I'm at the vet but please continue to share any thoughts or ideas that you might have. I don't have a good feeling about this. My poor guy.
 
Capoo said:
When you say darker, you mean black? Carbon black?
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Probably not quite black but close. It turned black when I switched him to Venison a couple months ago but after he threw up one night and had a gurgling tummy we took him off the Venison. His poop became a shade lighter but I can still hear his belly gurgling frequently. He went off the Venison about 1.5 month ago
 
MClarke087 said:
Probably not quite black but close. It turned black when I switched him to Venison a couple months ago but after he threw up one night and had a gurgling tummy we took him off the Venison. His poop became a shade lighter but I can still hear his belly gurgling frequently. He went off the Venison about 1.5 month ago
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I was afraid of the carbon black, because it could be caused by an internal bleeding. But in that case, you would have seen really black feces, so it's not the case.

Keep us posted!!!!
 
Dennis was just taken in the back again for an X-ray because the vet felt hard stool. She wants to see if he's blocked up. They're also going to run blood work for his kidneys. She does not want to test the pancreas just yet because of my tight budget, but if the other tests don't show anything then we will go forward with that test. She's also going to try and get urine from him to test for ketones but she said it's unlikely that this will happen because his bladder is empty.

I feel optimistic but I don't think they're grasping how different he's acting and how shaky he is because he's just laying on the table and letting them do whatever they want. I keep telling them that normally he's pretty aggressive at the vet but they don't seem to get how odd he's behaving. I'm so worried. Thank you all for always being here through the sleepless nights and the emergency vet visits. I would feel so alone if it wasn't for this message board.
 
Prayers for Dennis that it's something treatable and you can afford. Fight Dennis!
Virtual hugs to you. Hang in there, both of you.
 
They still haven't been able to get urine to test for DKA so he's getting fluids and staying for a few hours. His kidney levels are high. He also had some bad blood work that indicated EITHER a kidney infection or FIP. The vet is leaning towards FIP but is hopeful that this is not the case. All I know about FIP is that it's a virus that attacks all of the organs. Once it sticks it's a full blown disease that he will not be able to recover from. I won't have these answers for 3 more days.

If Dennis improves tonight he can come home. If he has not made a vast improvement in the next 24-48 hours the vet stated that he will have to be admitted to the ER. But that is not financially possible. This visit alone is going to cost $500 IF he recovers in the next couple hours which is very optimistic.

If anyone has experience with FIP please feel free to share your thoughts. I'm overwhelmed.
 
Sending prayers and healing vines for Dennis, and keeping the positive thought - kidney infections are a lot more common than FIP so hoping that's what's going on and they can have him on the road to recovery soon! :bighug::bighug::bighug:
 
First thing to keep in mind.....vets have an annoying tendency to diagnose FIP when they don't have any idea what's really going on....it's a diagnosis of doubt....they aren't sure what's happening, so throw out that FIP diagnosis....which just scares the crud out of everyone because if it's wet FIP, it's 100% fatal

FIP is a diagnosis that should only be diagnosed once all else is excluded. Also most cases can only be confirmed via necropsy and how many people actually elect to have that done? They're emotional and distraught at the sudden loss (because that is the nature of the beast that is FIP) and the last thing they want is to have their precious fur child put under the knife. It angers me no end the number of people I deal with whose cat has "FIP" The only thing more infuriating is those who have had any number of cats who had FIP and who were cured and are still living!

At the end of the day there is good, solid and reliable information available so there is no excuse any more for ignorance. For starters Dr, Diane Addie has a really good FIP Diagnostic Flowchart which covers everything, as well as her site www.catvirus.com

FIP flow chart.PNG
 
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I'm with Chris on this. The FIP diagnosis gets put on the table far too often and far too quickly. It is a diagnosis of exclusion so until ALL other possibilities have been investigated and ruled out, it shouldn't even be mentioned. I had that scare thrown at me for one of my civvies at the tender age of 2 because some of his dental pre-op blood values were off and the vet didn't know why. Ultimately I decided to go ahead with the dental surgery and it seems, getting rid of a couple of bad teeth made a world of difference in his bloodwork. He is now a healthy 6 yr. old.

A kidney infection or hard stool in his bowel would make Dennis feel pretty lousy. If there is no other indications of a bowel issue other than the hard stool the vet felt, maybe Dennis needs an enema. The hard stool, Dennis being gassy and the several bowel movements today, suggests to me a strong possibility of his symptoms being bowel related. I take it you were giving Dennis the Mirilax because he has been constipated. It may be he needs more help than the Mirilax is providing.
 
MrWorfMen's Mom said:
I'm with Chris on this. The FIP diagnosis gets put on the table far too often and far too quickly. It is a diagnosis of exclusion so until ALL other possibilities have been investigated and ruled out, it shouldn't even be mentioned. I had that scare thrown at me for one of my civvies at the tender age of 2 because some of his dental pre-op blood values were off and the vet didn't know why. Ultimately I decided to go ahead with the dental surgery and it seems, getting rid of a couple of bad teeth made a world of difference in his bloodwork. He is now a healthy 6 yr. old.

A kidney infection or hard stool in his bowel would make Dennis feel pretty lousy. If there is no other indications of a bowel issue other than the hard stool the vet felt, maybe Dennis needs an enema. The hard stool, Dennis being gassy and the several bowel movements today, suggests to me a strong possibility of his symptoms being bowel related. I take it you were giving Dennis the Mirilax because he has been constipated. It may be he needs more help than the Mirilax is providing.
Click to expand...

I'm starting to think you're right. He's been trying to poop unsuccessfully. The vet wasn't worried about constipation but after seeing him strain, I certainly am. I'll give him a little more time this morning to try but I'll be calling the vet if he isn't successfully soon.
 
Thank you everyfor all of the FIP information, I'm still reading through it all. Dennis came home about 12 hours ago. He is still walking funny which concerns me but the vet hopes that by getting some antibiotics into him he will improve. She said she cannot explain why he's walking funny but it could be kidney related because his kidney values are high. The blood work should tell us more as early as tomorrow. I'm glad everyone seems to agree that FIP is over diagnosed- you're giving me hope!
Also, the vet asked me to bring him back 2x a day to receive subq fluids but I'd rather not stress him out anymore so I asked to take the fluids home and do this myself, which is a first for me. Hopefully the fluids will help "flush" his kidneys. We won't have any answers until we get the blood test results but his appetite is back and I think that's a great sign.
 
I have lots of experience giving subQ fluids. Please post if you need help. There are some great videos just punch in giving subQ fluids to cats. One of the tricks is to warm the fluid before you give it to them. Giving it to them cold is much more uncomfortable for them. I use to warm up water in the microwave in a large bowl & then lay the bag & the line if you already have used it in the bowl to warm. Just be careful not to make it to warm. You can let a little of the fluid out on the inside of your wrist to test the temperature. I also would hang the bag from my shower curtain rod so that it would drip properly.
http://www.felinecrf.org/subcutaneous_fluids_tips.htm
 
I gave it to my elderly Birman who had arthritis. I've just had a look online and you have to be careful with dosage as it contains high levels of vitamin a. If you can run it past the vet I would do so or just try a tiny dose.
 
Microwaves are not recommended for warming fluids. Subq fluids are best warmed up by a heating pad or hot water bottle wrapped around it, or you can place the admin line in a bowl of hot(ish) water.

"Warming fluids in the microwave is not recommended because it is hard to get the right temperature so you may find the fluids are too hot in places."

Also, with some bags there is the possibility of chemicals from the bag leaching into the fluids.
 
SweetAngel said:
I gave it to my elderly Birman who had arthritis. I've just had a look online and you have to be careful with dosage as it contains high levels of vitamin a. If you can run it past the vet I would do so or just try a tiny dose.
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I don't think giving cod liver oil is the best solution for the reason mentioned. You'll find more than you ever wanted to know about feline constipation as well as some safer alternatives to cod liver oil on this website: Feline Constipation.Org.

If you choose to treat at home, please run any possible solutions by your vet before proceeding.

Ask someone from your vet's clinic to give you a hands on sub-q fluids demo.
Here's some additional help: How to Give Subcutaneous Fluids (Video).

Good luck!
 
Ria said:
I have lots of experience giving subQ fluids. Please post if you need help. There are some great videos just punch in giving subQ fluids to cats. One of the tricks is to warm the fluid before you give it to them. Giving it to them cold is much more uncomfortable for them. I use to warm up water in the microwave in a large bowl & then lay the bag & the line if you already have used it in the bowl to warm. Just be careful not to make it to warm. You can let a little of the fluid out on the inside of your wrist to test the temperature. I also would hang the bag from my shower curtain rod so that it would drip properly.
http://www.felinecrf.org/subcutaneous_fluids_tips.htm
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After a few tries I was able to get the needle into Dennis but now I think I inserted the needle too low.....I placed it below his shoulder blades by a couple inches.
He's been acting odd and just laying down a lot since I have him fluids. He's not interacting like he was before the fluids. And I just checked on him and his back is soaking wet. I KNOW the fluids went into him (this was 1 hour ago) so I can't explain how his back got all wet.
Is it possible to put fluids in the WEONG place?
Or for the fluids to leak out an hour after administering??
 
MClarke087 said:
Or for the fluids to leak out an hour after administering??
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Yes, fluids can leak out afterwards. After you remove the needle, gently pinch the skin together. This will help "close" the hole.

You might want to review the link I posted above for some tips and tricks to administering sub-q fluids:
How to Give Subcutaneous Fluids (Video).


Edited to add: Dry him off. He may feel cold or uncomfortable being wet.


 
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Jill & Alex (GA) said:
Yes, fluids can leak out afterwards. After you remove the needle, gently pinch the skin together. This will help "close" the hole.

You might want to review the link I posted above for some tips and tricks to administering sub-q fluids:
How to Give Subcutaneous Fluids (Video).


Edited to add: Dry him off. He may feel cold or uncomfortable being wet.
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Thank you! That video is very helpful!

Does the leaking also indicate that I put the fluids too low? Are there bad consequences to giving them in too low of a spot?
 
MClarke087 said:
Does the leaking also indicate that I put the fluids too low? Are there bad consequences to giving them in too low of a spot?
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Not necessarily. Placement could have been just fine. Picture a saddle on kitty's back. That's the area most administer sub-q fluids. Try gently pinching the skin for about 10 - 15 seconds after pulling the needle out. That helps close the hole.

Something to remember... a little bit of leakage can feel like a whole lot of leakage. Dry him off and forget about it. Sometimes it happens. It takes practice to feel comfortable giving fluids. You'll get there!
 
How much fluid did the vet recommend? And how much do you think he got? (Leaked fluid does look more than it actually is.) How long did it take the lump of fluid to disappear?

(I've had instances when after poking more than once in the same area, the fluids went in and then out the other hole. If you poked repeatedly in the same area, it can happen. Try a slightly different area if your first poke is unsuccessful.)
 
MClarke087 said:
After a few tries I was able to get the needle into Dennis but now I think I inserted the needle too low.....I placed it below his shoulder blades by a couple inches.
He's been acting odd and just laying down a lot since I have him fluids. He's not interacting like he was before the fluids. And I just checked on him and his back is soaking wet. I KNOW the fluids went into him (this was 1 hour ago) so I can't explain how his back got all wet.
Is it possible to put fluids in the WEONG place?
Or for the fluids to leak out an hour after administering??
Click to expand...

Sorry I am responding late to this but as others have mentioned it is normal to have some of the fluid leak out. They can feel a little funny after they get the fluids & sometimes get a bit of a lump where you gave them that can shift around. The lump happens less or is not as big if they are dehydrated. My guess is that you probably did fine. It can look like a lot when it is actually not. Glad the video someone suggested helped. It is hard to get the hang of it at first but you will get to know the feel of it. Before you know it you will feel much more comfortable. Tenting the skin before you put the needle in & pinching the area after you pull it out like others are recommending is really helpful.
 
I would still try to check ketones if you can get some urine. High kidney labs usually indicate acute renal failure which could be an infection, however, the dehydration and over work of kidneys from DKA usually causes some amount of acute renal failure as well. The kidney failure is usually reversible to a large extent once the cause is treated.
 
Hi, all. I just wanted to update you. I just got a call from the vet. She had sent his urine out to be tested for kidney disease and the test is negative. She said his kidneys look good but she is still waiting for the blood work to come back and tell us if he has FIP. She told me that because his kidney results came back normal she thinks we are more likely to get a positive result for FIP. That really scares me but I have to believe that we're jumping the gun on that particular disease, otherwise I'll start freaking out.
He looks so much better since coming back from the hospital. He's walking fine and he isn't shaking anymore. He finally went to the bathroom (#2) but there is a little blood in it. A very little. The vet does not think this indicates any bowel disease or inflammatory problem. He is going to stick to the Miralax for now and we will see if it helps.

I'll post more as soon as I hear back about his blood results. Thank you all so much for sticking by me through this.
 
I still think your vet is jumping the gun looking for zebras instead of horses for a diagnosis. While that can be a good thing in some cases, it also can be a source of a great deal of anxiety at your expense when more common easily treated conditions have not been ruled out. Sounds to me like Dennis was constipated and the extra fluids and Miralax are finally cleaning him out.
 
There isn't any blood test for FIP.....Period....Only a test for coronavirus and almost ALL cats will test positive for the coronavirus. Coronavirus is everywhere....only when it mutates will it cause FIP

It sounds like Dennis is doing better.....please don't worry about FIP...it really sounds like your vet is grasping at straws
 
Thank you all for keeping Dennis in your thoughts. I know the blood work has come back however the vet has been in a surgery all day so she has not told me what the results are yet. I'm starting to understand that the blood work won't give us an FIP positive or negative result- that's not how it works. But I guess there are certain aspects of his bloodwork on Saturday that made the vet think we are looking at FIP (I remember her saying that there were 3 values that were elevated to indicate FIP, but I don't know what they were).

Are there symptoms of FIP when it attacks? Dennis looks good and I'm wondering if he would be showing symptoms of this disease if he has it. The only symptoms I've read are belly bloating, lethargy and anorexia. He does not have any of these.

On a diabetic note- a few weeks ago Den's regular vet told me to stop obsessing and testing his BG and just shoot 5u 2x a day blindly. Obviously, I would never do that but I've been tapering back on his insulin simply because he's usually too low to get 5u. This new vet that Dennis saw on Saturday during his emergency visit agrees that I have Dennis on the right dose of insulin. She also complimented me on my spreadsheet whereas Den's regular vet never even took the time to acknowledge his spreadsheet! It felt amazing for a vet to tell me I am doing a good job instead of looking at me like I'm nuts. I think the old vet might be staying in Den's past.
Dennis has been on 2u/2x recently and he's doing fabulous- this morning he was only 149 before insulin so I think we're headed in the right direction. Now all we need is to rule out FIP.

As always, I have to say, I couldn't do this without all of you :) :) :)
 
FIP Update: I spoke to the vet and she confirms that Dennis tested positive for exposure to FIP however, she feels that he is not necessarily presenting with the active virus at this time. However, she is still concerned about him right now and she also told me to prepare for FIP to active at any time.

I asked her why she thinks the virus might be active right now, or may activate soon, and this is what she said:

- His instability, which could be FIP causing neurological issues, BUT he is walking much better
- How he presented with vomiting and constipation (although these have cleared up)
- His globulin levels are very high at 6.4 (normal is 2.8-4.8)
- He has enlarged kidneys combined with negative results for kidney problems (infections/disease)

Does anyone know how common it is for cats to be exposed to this, and how often the virus actives?

I don't have a grasp on this so I'm pretty nervous. I also am wondering if this means that my other cat has been exposed..... :(
 
I just googled FIP symptoms and read the WebMD link
I have no experience with this, but want to offer you hugs and wishes for you to stay positive as exposure to may not be the same as diagnosis of FIP.
 
Relax. Many cats have been exposed but very few ever develop FIP. I still think the vet is sounding alarms for no good reason.:arghh: The globulin elevation is exactly what my vet thought was an issue with my civvie. We then had an electrophoresis done.. When we went to the specialty hospital for the dental work, the vet thought his one kidney was enlarged and had him seen by an internist. They did an ultrasound but found nothing of note. I'm betting if they repeated the bloodwork on Dennis now that he is feeling better, it would all be normal again. My civvie came from a feral colony so there is probably a much higher chance he has been exposed to corona virus than the average and he is a happy, healthy little clown and neither of my other cats have had any issues either, even my 18 yr. old who I am sure would be the most vulnerable.
 
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