Vetsulin adjustment and force feeding advice urgently needed

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The elevated liver values can happen in DKA and can improve once the cat starts eating again. The problem is with the ketones + elevated billirubin + possible pancreatitis it's gonna be hard to get food in. I feel like a feeding tube might be the best solution and make it much easier for you to care for your cat at home.
 
Meya14 said:
The elevated liver values can happen in DKA and can improve once the cat starts eating again. The problem is with the ketones + elevated billirubin + possible pancreatitis it's gonna be hard to get food in. I feel like a feeding tube might be the best solution and make it much easier for you to care for your cat at home.
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that's why we are talking about it. Sounds scary though..open hole?!
 
Tanya and Ducia said:
can you please tell me more as to what to expect
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I have never, personally, had a cat with a feeding tube, but everything I have read and heard indicates that cats tolerate it very well, and that it aids tremendously in recovery!

I also belivee that it is fairly easy to care for and deal with at home, for the caregiver.
 
Dyana said:
Thank you for the update. Praying for her liver to get better. I'm glad her ketones are coming down. Sending eating vines and healing vines.
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Thanks for the update, Tanya. So glad Ducia is getting the care she needs, and that you aren't totally overwhelmed trying to figure out what to do with a very sick kitty. Aren't these people fantastic? Keeping you both in my thoughts and prayers. :bighug:
 
My experience was with a more invasive type of feeding tube (long time ago) called a PEG tube that was inserted through my kitty's side into her stomach. The length of tubing was wound up under a bandage that she wore like a wide belt with the valve end poking out on top behind her shoulders. I had to mix her wet food with water to make a thick soup that was sucked into a syringe. The syringe was attached to the valve end of the PEG tube and I had to slowly push the soupy food into the tube. It had to be slow so she wouldn't vomit. Afterward the valve had to be rinsed with water. This process was repeated about every 3 hours until she started eating a little on her own. As she ate more I reduced the tube feedings. She was very calm during the feedings and would sit quietly purring the whole time. Once she was eating well on her own the tube was removed by simply being pulled out of her side - no sutures or anything.
 
I've never dealt with a cat with a feeding tube, however, I feel the stress would be much less to deliver tube feeding rather than force feeding. Also, she would get more calories quicker and ability to deliver fluids and medications easily as well. Typical recovery from DKA is about 2 weeks-1 month (without complications) and relies on getting enough calories and enough insulin into the cat as well as maintaining fluid and electrolyte balance.

It's very important that your vet test potassium levels, as low potassium can affect muscles and the heart and is common in DKA. Potassium supplements are needed in a lot of DKA kitties. Phosporous and Hemoglobin level should be checked as well too as hemolytic anemia can happen in severe DKA, and is serious.

You won't really know if the liver issue is a temporary finding or something that is chronic until she recovers from the DKA. Labs are usually always wonky for a few weeks until recovery is complete.

Also, cats prone to DKA should be on an insulin that provides a -basal- (constant) dose once they are at home and somewhat stable. At the vet short acting insulin is usually used round the clock for a basal rate. This would be lantus or levemir. NPH does not provide proper basal coverage in a lot of cases, and due to the steep drops, is harder to get the right amount of insulin in the cat.
 
Meya14 said:
Also, cats prone to DKA should be on an insulin that provides a -basal- (constant) dose once they are at home and somewhat stable. At the vet short acting insulin is usually used round the clock for a basal rate. This would be lantus or levemir. NPH does not provide proper basal coverage in a lot of cases, and due to the steep drops, is harder to get the right amount of insulin in the cat.
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Sorry, just saw you are on vetsulin? This should provide basal coverage, but still might have somewhat steeper drops than other insulins.
 
Kris & Teasel said:
My experience was with a more invasive type of feeding tube (long time ago) called a PEG tube that was inserted through my kitty's side into her stomach. The length of tubing was wound up under a bandage that she wore like a wide belt with the valve end poking out on top behind her shoulders. I had to mix her wet food with water to make a thick soup that was sucked into a syringe. The syringe was attached to the valve end of the PEG tube and I had to slowly push the soupy food into the tube. It had to be slow so she wouldn't vomit. Afterward the valve had to be rinsed with water. This process was repeated about every 3 hours until she started eating a little on her own. As she ate more I reduced the tube feedings. She was very calm during the feedings and would sit quietly purring the whole time. Once she was eating well on her own the tube was removed by simply being pulled out of her side - no sutures or anything.
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has your kitty ever attempted to tear the tube off? Was she in any pain or discomfort for the first couple of days after fitting?
 
Let's get Ducia feeling better first....when they start to talk about sending her home, DCIN can help you out with Lantus too Tanya

I saw on your application that Lantus is what your vet preferred but you couldn't afford it
 
Meya14 said:
Sorry, just saw you are on vetsulin? This should provide basal coverage, but still might have somewhat steeper drops than other insulins.
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I am aware of it now, unfortunately, it was all we could afford. There maybe some help for us to get her on Lantus
 
Chris & China said:
Let's get Ducia feeling better first....when they start to talk about sending her home, DCIN can help you out with Lantus too Tanya

I saw on your application that Lantus is what your vet preferred but you couldn't afford it
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That's right, but if she is fit this afternoon than we are ok for the 24 hours stay - enough time to fit and observe the recovery without adding any extra costs, and the Vetsulin is all we have at home.
 
Tanya and Ducia said:
I am aware of it now, unfortunately, it was all we could afford. There maybe some help for us to get her on Lantus
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I'm so proud of you for not giving up on her, asking for help and accepting help, and doing what you need to do to get her well. I hope you will be able to get a good night's sleep tonight knowing she is getting the best care she can right now. Have a glass of something strong. Lol
 
JanetNJ said:
I'm so proud of you for not giving up on her, asking for help and accepting help, and doing what you need to do to get her well. I hope you will be able to get a good night's sleep tonight knowing she is getting the best care she can right now. Have a glass of something strong. Lol
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Thank you, and many thanks for insisting on contacting DCIN, over the years I grew extremely suspicious. My bad.
 
Thank you, I read the same.
Meya14 said:
The elevated liver values can happen in DKA and can improve once the cat starts eating again. The problem is with the ketones + elevated billirubin + possible pancreatitis it's gonna be hard to get food in. I feel like a feeding tube might be the best solution and make it much easier for you to care for your cat at home.
Click to expand...

Meya14 said:
I've never dealt with a cat with a feeding tube, however, I feel the stress would be much less to deliver tube feeding rather than force feeding. Also, she would get more calories quicker and ability to deliver fluids and medications easily as well. Typical recovery from DKA is about 2 weeks-1 month (without complications) and relies on getting enough calories and enough insulin into the cat as well as maintaining fluid and electrolyte balance.

It's very important that your vet test potassium levels, as low potassium can affect muscles and the heart and is common in DKA. Potassium supplements are needed in a lot of DKA kitties. Phosporous and Hemoglobin level should be checked as well too as hemolytic anemia can happen in severe DKA, and is serious.

You won't really know if the liver issue is a temporary finding or something that is chronic until she recovers from the DKA. Labs are usually always wonky for a few weeks until recovery is complete.

Also, cats prone to DKA should be on an insulin that provides a -basal- (constant) dose once they are at home and somewhat stable. At the vet short acting insulin is usually used round the clock for a basal rate. This would be lantus or levemir. NPH does not provide proper basal coverage in a lot of cases, and due to the steep drops, is harder to get the right amount of insulin in the cat.
Click to expand...
 
Tanya and Ducia said:
Thank you, I read the same.
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Meya14 said:
Sorry, just saw you are on vetsulin? This should provide basal coverage, but still might have somewhat steeper drops than other insulins.
Click to expand...
Vetslin is all we have at home now but some Lantus is heading our way and should be delivered on Tuesday. We are currently searching for some one in San Diego area who may be able to borrow us some Lantus to get us by until Tuesday. The thing is the doctor said that Ducia should be taken from short acting insulin and returned to long management one. The time to is at 8pm pacific time. Hopefully someone maybe able to help here in CA. She will have Tube fitting procedure in a few hours. Her BG went up at 4 pm from 89 at noon to 218 but that what was expected. She needs to eat regularly. Doctor assured me that she barely ever saw any complications with cats with Tubes. Besides there is some antibiotics in Ducia's system from the shot this morning at the hospital.
I cannot tell you how relieved and happy I am to find this board. Thank you all! Thank you DCIN!
 
Tanya and Ducia said:
We are currently searching for some one in San Diego area who may be able to borrow us some Lantus to get us by until Tuesday. The thing is the doctor said that Ducia should be taken from short acting insulin and returned to long management one. The time to is at 8pm pacific time. Hopefully someone maybe able to help here in CA.
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Just an update for those of you watching.....we're pretty sure we've secured some Lantus to get to the vets office so they can start Ducia on it while she's still there......one of DCIN's adoptive mom's has a pen to donate and lives in the area
 
JanetNJ said:
How are things today?
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The Tubes were fitted in successfully, "easy one" the Dr said, she was fed thru it last time at noon and kept the food and oral medication in, BG@8am+5 was 256 (I meant to say that 5 hours after the 8 am shot her BG was 256, is that the right format to say it?). The number is elevated but it was expected. She is on antibiotic for liver, painkiller for pancreatitis, anti-nausea, a little of vitamin K. The ketones in her urine are at a trace amount level, glucose in her urine is down from 2000 to 500 yesterday evening. She is still sleepy from anastezia but it is ok under the circumstance. I visited at 8 am, she is conscious, walked! toward my voice, Groomed herself ! These are maybe little things but are indicative of progress. Last time I ve seen her she was laying on her side after the procedure. We finally saw our doctor, he is positive. We are going to pick her up after 4 and care for her at home.
I am going to open a new thread on the main page if could figure it out. I apologize for snooping but I looked at your spreadsheet and it may finally start making sense to me. I am practicing insulin shots with needle and a dummy right now but it is still clumsy. My only supervised real shot is at the next shot time at 8pm while my husband-human medic is at home. Tomorrow morning I have to do it my self. We will be practicing BG teets tonight too
 
Tanya and Ducia said:
The Tubes were fitted in successfully, "easy one" the Dr said, she was fed thru it last time at noon and kept the food and oral medication in, BG@8am+5 was 256 (I meant to say that 5 hours after the 8 am shot her BG was 256, is that the right format to say it?). The number is elevated but it was expected. She is on antibiotic for liver, painkiller for pancreatitis, anti-nausea, a little of vitamin K. The ketones in her urine are at a trace amount level, glucose in her urine is down from 2000 to 500 yesterday evening. She is still sleepy from anastezia but it is ok under the circumstance. I visited at 8 am, she is conscious, walked! toward my voice, Groomed herself ! These are maybe little things but are indicative of progress. Last time I ve seen her she was laying on her side after the procedure. We finally saw our doctor, he is positive. We are going to pick her up after 4 and care for her at home.
I am going to open a new thread on the main page if could figure it out. I apologize for snooping but I looked at your spreadsheet and it may finally start making sense to me. I am practicing insulin shots with needle and a dummy right now but it is still clumsy. My only supervised real shot is at the next shot time at 8pm while my husband-human medic is at home. Tomorrow morning I have to do it my self. We will be practicing BG teets tonight too
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I'm so glad everything went well! Grooming is a super good sign!

You are welcome to look at anyone's spreadsheets.... We make them public so anyone can see. :). We go by the +1, +2, ect because we are all in different time zones and do shots at different times. If you want help setting one up we can help with that.
 
JanetNJ said:
I'm so glad everything went well! Grooming is a super good sign!

You are welcome to look at anyone's spreadsheets.... We make them public so anyone can see. :). We go by the +1, +2, ect because we are all in different time zones and do shots at different times. If you want help setting one up we can help with that.
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I will definitely need help with it and with the rest. I will log in later on after we settled Ducia and I 'll post updates. She is on Lantus now. We are hoping to be briefed and sent home with detailed instructions but I appreciate any help with all of it. I am ignorant to say the least re feline diabetes or handling needles. For instance do you test right before the shot on empty stomach or do you feed first, wait X amount of time and than test and do shot, or what. There was a major crisis this morning to do with miscommunications/language barrier so my brain is partially shut down. Sorry if I do not make much sense now.
 
With Lantus, you Test, Feed, Shoot.....You don't want them to have food for the 2 hours immediately before shots

You Test (to make sure they're high enough for insulin), Feed (to make sure they're at least willing to eat but if she has a tube, this isn't important) and Shoot......all within 5-10 minutes
 
Chris & China said:
With Lantus, you Test, Feed, Shoot.....You don't want them to have food for the 2 hours immediately before shots

You Test (to make sure they're high enough for insulin), Feed (to make sure they're at least willing to eat but if she has a tube, this isn't important) and Shoot......all within 5-10 minutes
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...although I think the time frame on the feeding can be relaxed with tube-feeding. I've never done it so I don't know how long it takes to get a meal in, but I suspect 5-10 minutes might be ambitious. Just as long as the whole meal is on-board before the insulin takes effect (a couple hours after the shot, so plenty of time), it should be fine.
 
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