? Regulation after DKA, ketone prone & liver issues. Possible?

[Darnell & Sprocket (GA)]

Hi all.
Sprocket has been diabetic since 3/15. He was dka when diagnosed. 8 days in ER hospital. Almost died. Started lantus. I had trouble testing with pet meter as he is not a bleeder. I didnt find groups till later. He had reaction to vaccines in 3/16. In hospital 2 nights.
Had dental 9/16. I tried to test more without much luck.
I tried to find better food n get him to eat as he was so finicky. I ended up giving FF grilled with gravy alot as he would eat it. Not realizing how many carbs I was feeding until I found Dr.Piersons List in March of 2017. He went dka again in 3/17. Along with cholangiohepititis (liver disease). He had ketones 4 times in March-April. He was on antibiotics for about 6 -8 weeks. He is still on liver meds, ursodiol.
I started testing more with human meter as its needing much less blood.
Been trying to get him in better control since. July we had death in family n did alot of crying. Sprocket got idieopathic cystitis and more meds for a couple of months. A few weeks he had this before he stopped having the peeing attacks. Meds raised his bg alot. Had issues with sugar in meds.
Fall came. He was better but still unregulated.
He went from eating 12-15 oz a day to @9oz a day then had a weird thing around thanksgiving. Would barely eat, @6oz, but wasnt acting right. Vet said to skip 1 dose to see if it makes him feel better as it seemed he was dropping like crazy as he earned 3 reductions in less than 2 weeks.
While i have learned alot and tried to change food. Have gone through so much food. He gets sick of food easily. Friskies now mostly, some proplan & ff pates.
Mostly give 3-6 carb food. Have higher when needed.
I know I am anxiety person too so I try my best. Got my own medical issues n I need to sleep so I do feed sometimes so I can sleep.

Overall. Trying to get him to be under 300 or ideally under 250.
Is this possible?
Is he simply eating too much?
If I go up on dose he earns reductions at odd times.
So what am i missing?
With his history can he be regulated?
What am I missing?
Will it just take longer? We are at about 10 months now.
With dka 2x and ketone prone amd liver issues can he be regulated like I want?
Has other kitties with his history been regulated??

 

[Myagi (GA) and Heidi]

Not all inclusive, cause I couldn't possibly know, but most of you have either been around long and know who to tag or have personal experience with fd and multiple other kitty health issues. Thanks in advance fur helping Myagi's friend Sprocket!

@Wendy&Neko @Stacy & Asia @Marje and Gracie @manxcat419 @Critter Mom @PussCatPrince @Tracey&Jones @tiffmaxee @Tanya and Ducia @Tricia Cinco(GA) & Harvey @Becky & Baby Girl Kitty @JanetNJ @Kris & Teasel @Red & Rover (GA)
@Alicia & Maggie
@Osha

 

[Nan & Amber (GA)]

I've heard @Sandy and Black Kitty refer to B.K. as "the cat no one thought would ever go OTJ"-- similar in terms of multiple DKA, not sure about any liver issues. No guarantee of anything, of course, just saying that cats can and do surprise us every day. They are remarkably resilient creatures, but regulation can take time, especially when there are multiple issues going on.

All any of us can do is to do what we can for our kitties, when we can do it. The best thing for Sprocket is for you to stay healthy enough to care for him-- you're doing a great job!

 

[Wendy&Neko]

For the food question on amounts, is Sprocket at his ideal weight? If not, is he gaining or losing towards that goal? Let the scale be your guide on how much to feed him.

And to answer the DKA question, yes, kitties with multiple complications can become regulated, even after time. It took Neko over a year before she stopped giving me reds. Then gradually the pinks went away,..... Well, almost. My goal was under renal threshold, and we mostly got there, except when something new was added to the list or something flared up.

 

[Darnell & Sprocket (GA)]

For the food question on amounts, is Sprocket at his ideal weight? If not, is he gaining or losing towards that goal? Let the scale be your guide on how much to feed him.

And to answer the DKA question, yes, kitties with multiple complications can become regulated, even after time. It took Neko over a year before she stopped giving me reds. Then gradually the pinks went away,..... Well, almost. My goal was under renal threshold, and we mostly got there, except when something new was added to the list or something flared up.

Last i weighed him by human scale with weighing my bf first n then with Sprocket. He weighed 17 lbs. 11/29/17. We weighed him.
Did again just now. 16.5lbs 1/8/18.
He is a big cat and half Main Coon. So 15-16 is a good weight.. so he could lose a little more. He has been more active in past couple of months.

Also gonna tag @Meya14

 

[Sandy and Black Kitty]

How old is Sprocket? How old was he when diagnosed?

I've heard @Sandy and Black Kitty refer to B.K. as "the cat no one thought would ever go OTJ"-- similar in terms of multiple DKA, not sure about any liver issues.

Yes, on top of having multiple DKA episodes he was FIV+, had IAA and also had liver issues.
BK was indeed the cat no one, myself included, thought would get regulated much less go OTJ.

If I go up on dose he earns reductions at odd times.

in the sugar dance, the kitty always leads and we follow.

With dka 2x and ketone prone and liver issues can he be regulated like I want?

BK is proof that anything is possible, although there are no guarantees.

Will it just take longer? We are at about 10 months now.

Healing takes time the more healing required the more time required. The road can have a lot of ups and downs.

What am I missing?

Is there any chance he is in pain?

Please test for ketones a couple times per week; more often if he seems 'off' in any way.
Forewarned is forearmed.

 

[Darnell & Sprocket (GA)]

How old is Sprocket? How old was he when diagnosed?
Yes, on top of having multiple DKA episodes he was FIV+, had IAA and also had liver issues.
BK was indeed the cat no one, myself included, thought would get regulated much less go OTJ.

in the sugar dance, the kitty always leads and we follow.
BK is proof that anything is possible, although there are no guarantees.


Healing takes time the more healing required the more time required. The road can have a lot of ups and downs.
Is there any chance he is in pain?

Please test for ketones a couple times per week; more often if he seems 'off' in any way.
Forewarned is forearmed.

Hi. Sprocket was @6yrs when he was diagnosed. So he is almost 9 now. Dx'd 3/15.

Tell me more about BK. How long before he was OTJ?

I dont think Sprocket is in pain. He was on buprenex for about 2 months for the cystitis for his inflamed bladder. He has been great since. Its been about 4 months or a little longer since last pee episode.
I got 2 huge little boxes for 2 cats. I try to test his ketones but he tends to go pee when i am sleeping or not paying attention. He is sneaky...lol. i will try to watch him more n get more tests.
Thanks

 

[Sandy and Black Kitty]

Tell me more about BK. How long before he was OTJ?

It was 21 months
(click to enlarge)

.

He is sneaky...lol. i will try to watch him more n get more tests.

You must be sneakier

 

[Critter Mom]

I try to test his ketones but he tends to go pee when i am sleeping or not paying attention.

It might be worth considering getting a blood ketone meter. The test strips are more expensive than those for glucose testing but you'd only be using a couple each week. It would make ketone testing much more predictable for you and Sprocket.


Mogs
.

 

[Meya14]

My cat had very severe DKA when he was diagnosed and almost died as well. After he recovered from the episode, it took us 6+ months before we even saw numbers less than 300. Then, one day, suddenly his numbers started going down and we hit reduction after reduction very rapidly (from 7 units twice a day to 0.5 units twice a day). We took him off the insulin for 6 months and he had normal numbers. Then after about 6 months, he started to creep back up and needed to go back on. He currently is stable at 1 unit -ONCE- a day, and all sugars are 60-100 range. We are even able to skip days here and there without much change. We are happy with this situation, even though he's not OTJ, he's extremely stable.

For you, the liver disease will make it pretty important to monitor appetite and weight. You don't really want him losing weight. Make it a goal to weigh him and try to feed what you can to keep the weigh where it is. Weight loss puts stress on the liver. Monitoring weights will also help keep you safe from another episode of DKA, as often weight loss is the first warning signs.

The other thing that helped me is something a Dr once told me - If sugars are high, you HAVE to be aggressive with the insulin. Do regular dose increases, don't wait. There is insulin resistance that happens when the cat is in high numbers for more than a few days which makes it harder to regulate. You have to get ahead of this and have a few days of normal numbers before his insulin need will come down.

 

[Darnell & Sprocket (GA)]

My cat had very severe DKA when he was diagnosed and almost died as well. After he recovered from the episode, it took us 6+ months before we even saw numbers less than 300. Then, one day, suddenly his numbers started going down and we hit reduction after reduction very rapidly (from 7 units twice a day to 0.5 units twice a day). We took him off the insulin for 6 months and he had normal numbers. Then after about 6 months, he started to creep back up and needed to go back on. He currently is stable at 1 unit -ONCE- a day, and all sugars are 60-100 range. We are even able to skip days here and there without much change. We are happy with this situation, even though he's not OTJ, he's extremely stable.

For you, the liver disease will make it pretty important to monitor appetite and weight. You don't really want him losing weight. Make it a goal to weigh him and try to feed what you can to keep the weigh where it is. Weight loss puts stress on the liver. Monitoring weights will also help keep you safe from another episode of DKA, as often weight loss is the first warning signs.

The other thing that helped me is something a Dr once told me - If sugars are high, you HAVE to be aggressive with the insulin. Do regular dose increases, don't wait. There is insulin resistance that happens when the cat is in high numbers for more than a few days which makes it harder to regulate. You have to get ahead of this and have a few days of normal numbers before his insulin need will come down.

Thanks Meya.
Great to know. Glad ur kitty is doing better. We are trying to get a baby scale but they have been so $$ but will keep trying to get one. I know his liver numbers are normal but vets said he should probably be on those meds for his life now with so many issues.

I try to keep him in yellows or blues. He tends to go pink for amps often. I noticed the jets overhead(we are on launch/landing path for air force base jets in backyard over 100 ft trees) tend to put him in pinks if they are quiet awhile before. He is mostly used to them but when they are quiet then come back he gets jumpy.
I will raise his dose if in pinks for more than a day. He will usually come down. He is floating between 2.5u - 3u mostly.
Think that is enough?

 

[Meya14]

You want to aim for mostly blues. Even numbers in the yellows for extended periods can cause more insuln resistance.

 

[Darnell & Sprocket (GA)]

You want to aim for mostly blues. Even numbers in the yellows for extended periods can cause more insuln resistance.

We always aim for blues but dont always get it. Its like he gets in blues and then goes up. Once in a while he will surf for hours. Usually when I try to go up on dose to bring him down in blues it usually doesnt work. He will go under 100 and earn reductions. Hard to get him to surf in blues

 

[Meya14]

Yeah, with our kitty, we had to hold the dose until we received 3 numbers that earned reductions to break the insulin resistance. It took a lot of testing at that time, and I knew how to feed to keep him safe at the lower numbers. Others might have experience with this, maybe want to chime in about if it might work for your kitty.