Back with Tibby

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Marsha & Tibby

Marsha & Tibby

Member Since 2016
Tibby had a long honeymoon, but his diabetes is back, and I didn't catch it as soon as I should have because of so many other things going on. Thankfully, his insulin is still good, but expires this month. I have kept it in the fridge and this pen hasn't been tapped and is nice and clear. I think he was just passing into DKA by the time I got him to the clinic.

They said there were hardly any ketones in his urine, but his glucose was 600, potassium low at 2.5, creatinine and BUN high. Can't remember the numbers and don't have the paperwork with me. I think 101 for BUN and near 4 for creatinine, but maybe that was last year? He was not as bad off as last year, but is in a dangerous situation. My local clinic wants to send him to the emergency clinic where he can get more intensive care, and acid/base balance can be monitored, but I can't afford it. I am still paying for last month's vet emergency (different cat, different health issue). Tibby is in the hospital now, getting IV fluid, potassium, and then they will start the insulin later after getting the potassium level up. But I will have to take him home tonight for home nursing. He does very well on sub q fluid at home, very tolerant.

Last year when Tibby had his crisis, I didn't have a job. Now I do, but still getting back on my feet financially. This morning the vet said it wouldn't be unreasonable to consider euthanasia because Tibby really should be in the emergency clinic, hospitalized for a week at around $5000. Last year's crisis came to under $1000 with home nursing, but the vet reminded me the mortality rate is very high, and I would be more upset than I am now if I tried home nursing and he died. But I don't have much choice. He is currently comfortable (but tired) at the clinic and the tech commented that he doesn't LOOK sick on the outside.
 
Sorry your kitty is out of remission. I think you can care for him at home with some help here. I disagree with the vet...personally, I would feel worse if I just went for euthanasia and did not try to care for my cat first. Unless you feel cat is suffering terribly, of course. Does he come home tonight? Hugs & healing to you and Tibby.
 
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Sorry Tibby is back on the juice, but good that the ketones were fairly low. Did you get a number on that? Trace ketones can be managed at home. Sounds like he might have some kidney issues though. Do you have a reading on his phosphorus, SDMA, or urine specific gravity? You may have to look for lower phosphorus food than the Fancy Feast.
 
Tibby came home with me for the night, and is going back to the vet first thing in the morning. There were only trace ketones, if any (the urinalysis report says negative). It appears the big problem is kidney failure. Dilute yellow, protein 2+, specific gravity 1.016. They gave him a sub-q bolus before going home for the night, but the main thing he wanted to do right away was drink water. He ate at the vet's office only 2-3 hours before I picked him up, so he didn't eat at home until later, except for a few treats at dinner. Very slow to eat though, presumably due to the 3.8 creatinine, BUN 103 (improved from morning, after IV fluids all day). Glucose dropped to 478 on fluid therapy alone, potassium improved from 2.5 to 3. Phosphorus went from 8.6 in the morning to 10.8 in the afternoon. (last year at initial presentation it was 13.8)

Vet said she would start insulin in the morning. She was hesitant due to his low potassium level. It's up to me whether I want to take the chance and start it at home. Too late I realized I left his insulin at the vet. I do have one pen that expired last month, still in the fridge and untapped.
 
No luck getting a viable drop of blood from Tibby's ear. I had the same trouble last year, but people here gave me some tips. Tibby ate some ground turkey around 1 am, and then again this morning when all the cats had breakfast. I laid on the floor nearby so that others wouldn't steal his food. He ate very slowly, but did eat a decent amount.

Time to go take a shower, drop Tibby at the vet, and then off to work. But all I really wanna do is lay down.
 
Yesterday morning at 09:05, Tibby got 1 unit of insulin at the vet. BG was 423 at the time. It dropped to 94 by 17:20 (at vet's office), and 63 at 23:15 at home. I was supposed to give him 200ml of subq fluid at bedtime, but didn't because of the low BG. The first day he was at the vet, his BG dropped from 604 to 423 solely on subq fluid (with potassium). I worked on getting food into him through the night. He only eats very small amounts at a time. Had to syringe feed him at the low point, but he wasn't symptomatic. Of course I didn't hit on a really neat trick until about 05:00. I used 3 fingers to scoop some recovery diet and he licked it all up from my fingers. Caution: use a spoon to get the last bit of food out of the can, not your fingers!! Sharp edge! Tibby might have gotten a little extra flavor in the last bit, LOL. He is going back to the vet for the day while I am at work, then I pick him up tonight again. Kidney numbers improved from a high of 4.3 for creatinine, down to 2.3; and from 110 for BUN down to 54. Potassium was still a tad below normal, but improving.
 
Another tip for when BG is getting a little low: dangle a string in front of the cat, and move it around. This will help gauge alertness and coordination, IF the cat is one that likes to play with string.
 
Tibby came home last night and we both got some sleep. His appetite is back, and he even went up the stairs early this morning. Now we begin working towards our new normal. Recheck at the vet in 2 weeks.
 
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