Is my diabetic cat stabilized?

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Cowboycat

Member Since 2019
Hi All
One of my two cats -Cowboy- was diagnosed with diabetes two months ago on Christmas Day. He ended up in urgent care with diabetic ketoacidosis. Very scary! After he came home, and I got over the initial shock, I’ve been committed to scheduled shots twice a day and a high protein diet. Under vet supervision and monitoring, he is now up to 3 units of vetsulin twice a day. Up to this point he has been ravenous and I’m guessing unregulated. Just yesterday he started to seem less interested in food. He eats but with less gusto and leaves some in the bowl. Of course I’m terrified he’s slipping into ketoacidosis again but I also wonder if he’s simply getting more regulated and stable. Any thoughts on this? This forum has been a miracle during the last two months of this journey. Thank you!
 
It’s very hard to say with no BG data to look at. If you’ve been lurking on the forum you know we’re big proponents of testing BG at home and logging the results in our special spreadsheet. Without that we’d be guessing. Have you considered testing his BG yourself?
 
Of course I’m terrified he’s slipping into ketoacidosis again but I also wonder if he’s simply getting more regulated and stable. Any thoughts on this?
You musts be vigilant after a hospitalization for DKA.

Are you testing daily for the presence of ketones, either in his urine using Ketostix or his blood using a meter designed to detect ketones in the blood? Any result above "trace" warrants a call to your vet.

The factors in the equation that sets the stage for the development of ketones are:
not enough calories+not enough insulin+infection/inflammation/systemic stress.

You see the way DKA works is that when there is not enough energy from food making it into the cells, the body will breakdown fat and protein to try and fulfill the need for more metabolic energy. The excessive breakdown of these stored reserves creates a toxic by-product - ketones. As ketones build up in the blood stream, the resulting pH and electrolyte imbalances can very quickly develop to life threatening levels , a state of DKA.

Just yesterday he started to seem less interested in food.
With the recent DKA history, that is a red flag. Please know that ketones can quickly develop to life threatening levels. My Black Kitty once went from 'negative' to 'large' in exactly 24 hours.

Regarding his being regulated and stable, without historical BG test result data I that cant be determined.
 
Up to this point he has been ravenous and I’m guessing unregulated. Just yesterday he started to seem less interested in food. He eats but with less gusto and leaves some in the bowl. Of course I’m terrified he’s slipping into ketoacidosis again but I also wonder if he’s simply getting more regulated and stable. Any thoughts on this?
Hi, eating less food could mean that he's improving and just doesn't need as much, or that there is something amiss. Without any blood test data it's not possible to know what's going on though...

As has been said above it's really important to monitor your kitty for ketones given his history.
You can test his urine using test strips such as Ketostix or Keto-Diastix. The former test for ketones, the latter test for ketones and also urine glucose. And since you are not yet testing blood glucose at home the latter may be useful to you. A urine glucose test is not as useful as a blood glucose test, but it will give you an indication of how much glucose is being excreted in the urine since the last time he peed.

The test involves dipping the end of the test strip into a drop of pee, timing for a specific number of seconds (very important), and then comparing the result to the coloured samples on the product container.
Anything above a 'trace' ketone result is considered a reason to contact your vet ASAP. And given your cat's history I would suggest talking to your vet even if you just get a 'trace' reading.
Not all ketones are registered by the strips, so also have an awareness of how your kitty's breath smells. A smell that is fruity or like acetone can also indicate ketones.

Crumpling plastic food wrap loosely over the litter in the tray is often a good way to get a little pee sample. Or, if you use clumping litter you may be able to poke the end of the test strip into a freshly wet pee clump. Keeping only a very shallow layer of litter in the tray can help, since the pee isn't so easily soaked up, and you may even get a nice little pool of pee on the bottom of the tray. ...If your cat isn't too private about their toilet habits you may, as some do, be able to hold the test strip in the urine stream while your cat is peeing, or use a spoon to catch a little pee. :smuggrin:

If you get a really dark/high result on the strip for urine glucose then that would indicate that your kitty's blood glucose has been high since the last time he peed. If you get a 'negative' result for urine glucose than that would mean that the cat's blood glucose has not been high enough for the body to need to excrete it via the urine (below what is called the 'renal threshold')
The information a urine glucose test gives is limited though, and doesn't compare to a 'real time' blood glucose test. Do please consider learning to test blood glucose at home, especially given your kitty's DKA history. It really could help you to keep him safe from a recurrence.

'Most' people who try hometesting of blood glucose do manage to do it just fine, and 'most' cats will tolerate it well if rewarded with yummy treats or a cuddle. But while some cats (and their humans) take to hometesting like proverbial 'ducks to water' with no issues at all, some others do find it a challenge initially, just like learning anything new.
In a nutshell, a test involves pricking the outer edge of the ear to get a tiny drop of blood, transferring that to a test strip in a glucose meter, letting it count down and give the result, and rewarding the kitty with a treat or a cuddle (or whatever else the kitty really loves.)

If you can learn to test blood glucose you could also consider getting a blood ketone meter, which gives a more accurate and 'real time' result than the urine test strips do.

Eliz
 
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